Survival Nomogram for Stage IB Non-Small-Cell Lung Cancer Patients, Based on the SEER Database and an External Validatio
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ORIGINAL ARTICLE – THORACIC ONCOLOGY
Survival Nomogram for Stage IB Non-Small-Cell Lung Cancer Patients, Based on the SEER Database and an External Validation Cohort Zhichao Zuo, MD1, Guochao Zhang, MD2, Peng Song, MD2, Jing Yang, MD3, Shuiting Li, MD1, Zhi Zhong, MD1, Qinghao Tan, MD1, Liming Wang, MD1, Qi Xue, MD2, Shugeng Gao, MD2, Nan Sun, MD, PhD2, and Jie He, MD, PhD2 1
Department of Radiology, Xiangtan Central Hospital, Hunan, China; 2Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; 3Department of Plastic Surgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Hubei, China
ABSTRACT Objective. This study aimed to construct a nomogram to effectively predict the overall survival (OS) of patients with stage IB non-small-cell lung cancer (NSCLC). Methods. In total, 5513 patients with stage IB NSCLC were extracted from the Surveillance, Epidemiology, and End Results (SEER) database and used as the training cohort. We enrolled 440 patients from the Cancer Hospital, Chinese Academy of Medical Sciences, for the external validation cohort. A nomogram was constructed based on the risk factors affecting prognosis using a Cox proportional hazards regression model. The discrimination and calibration of the nomogram were evaluated by C-indexes and calibration curves. Results. Six independent risk factors for OS were identified and integrated into the nomogram. The discrimination
of the nomogram revealed good prognostic accuracy and clinical applicability as indicated by C-index values of 0.637 (95% CI 0.634–0.641) and 0.667 (95% CI 0.656–0.678) for the training cohort and the external validation cohort, respectively. Additionally, the patients were divided into two groups according to risk (sumscore [ 185), and significant differences in OS were observed between the high-risk and low-risk groups in the training and external validation cohorts (P \ 0.001). Finally, chemotherapy was significantly associated with OS in patients with differentiation grades II–IV (P = 0.004) and patients with adenocarcinoma (P = 0.005). Conclusion. This nomogram provides a convenient and reliable tool for individual evaluations and clinical decision-making for patients with stage IB NSCLC; among these patients, those with differentiation grades II–IV or adenocarcinoma could benefit from chemotherapy.
Zhichao Zuo and Guochao Zhang contributed equally to this work.
Electronic supplementary material The online version of this article (https://doi.org/10.1245/s10434-020-09362-0) contains supplementary material, which is available to authorized users. Ó Society of Surgical Oncology 2020 First Received: 24 May 2020 Accepted: 12 September 2020 N. Sun, MD, PhD e-mail: [email protected] J. He, MD, PhD e-mail: [email protected]
Lung cancer is the most common malignant tumor in the world and ranks first in both morbidity and mortality.1 Approximately 8
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