A prognostic model for elderly patients with squamous non-small cell lung cancer: a population-based study

Chen, Siying; Gao, Chunxia; Du, Qian; Tang, Lina; You, Haisheng; Dong, Yalin

doi:10.1186/s12967-020-02606-3

Cited by 16 publications

(17 citation statements)

References 37 publications

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“…The previous studies reported that patients with NSCLC diagnosed at the age over 80 years contributed to worse LCSS and OS, 26 , 27 which were consist with our investigation. Worse nutritional status, reduced physiological reserve, basic diseases and poor tolerance to cancer treatment in the older group might be explanations.…”

Section: Discussionsupporting

confidence: 92%

Construction and validation of prognostic nomograms for elderly patients with metastatic non‐small cell lung cancer

Sun

Liu

Yang

et al. 2022

Clinical Respiratory J

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Background Metastatic non‐small cell lung cancer (NSCLC) is mostly seen in older patients and is associated with poor prognosis. There is no reliable method to predict the prognosis of elderly patients (≥60 years old) with metastatic NSCLC. The aim of our study was to develop and validate nomograms which accurately predict survival in this group of patients. Methods NSCLC patients diagnosed between 2010 and 2015 were all identified from the Surveillance, Epidemiology, and End Results (SEER) database. Nomograms were constructed by significant clinicopathological variables (p < 0.05) selected in multivariate Cox analysis regression. Results A total of 9584 patients met the inclusion criteria and were randomly allocated in the training (n = 6712) and validation (n = 2872) cohorts. In training cohort, independent prognostic factors included age, gender, race, grade, tumor site, pathology, T stage, N stage, radiotherapy, surgery, chemotherapy, and metastatic site (p < 0.05) for lung cancer‐specific survival (LCSS) and overall survival (OS) were identified by the Cox regression. Nomograms for predicting 1‐, 2‐, and 3‐years LCSS and OS were established and showed excellent predictive performance with a higher C‐index than that of the 7th TNM staging system (LCSS: training cohort: 0.712 vs. 0.534; p < 0.001; validation cohort: 0.707 vs. 0.528; p < 0.001; OS: training cohort: 0.713 vs. 0.531; p < 0.001; validation cohort: 0.710 vs. 0.528; p < 0.001). The calibration plots showed good consistency from the predicted to actual survival probabilities both in training cohort and validation cohort. Moreover, the decision curve analysis (DCA) achieved better net clinical benefit compared with TNM staging models. Conclusions We established and validated novel nomograms for predicting LCSS and OS in elderly patients with metastatic NSCLC with desirable discrimination and calibration ability. These nomograms could provide personalized risk assessment for these patients and assist in clinical decision.

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Section: Discussionsupporting

confidence: 92%

Construction and validation of prognostic nomograms for elderly patients with metastatic non‐small cell lung cancer

Sun

Liu

Yang

et al. 2022

Clinical Respiratory J

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“…The differences in these results may indicate marriage is not a direct influence on tumor prognosis, which could result from several factors, such as sociodemographic differences in culture and economy between regions. Chen et al also noted that the current studies only recorded marital status at the time of diagnosis and did not record information on changes in marital status after diagnosis, which could lead to biased results (113). On the other hand, the present data used in most relevant studies we reviewed are from 10 years ago, and the data source is relatively single.…”

Section: Marital Statusmentioning

confidence: 86%

“…A prognostic model of squamous cell carcinoma in the elderly (115,116). Overall, unmarried patients have worse overall survival than those who had been married (married or divorced) (112)(113)(114)(115)(116)(117)(118). The differences in these results may indicate marriage is not a direct influence on tumor prognosis, which could result from several factors, such as sociodemographic differences in culture and economy between regions.…”

Section: Marital Statusmentioning

confidence: 99%

A narrative review of prognosis prediction models for non-small cell lung cancer: what kind of predictors should be selected and how to improve models?

2021

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Objective: To discover potential predictors and explore how to build better models by summarizing the existing prognostic prediction models of non-small cell lung cancer (NSCLC).Background: Research on clinical prediction models of NSCLC has experienced explosive growth in recent years. As more predictors of prognosis are discovered, the choice of predictors to build models is particularly important, and in the background of more applications of next-generation sequencing technology, gene-related predictors are widely used. As it is more convenient to obtain samples and followup data, the prognostic model is preferred by researchers.Methods: PubMed and the Cochrane Library were searched using the items "NSCLC", "prognostic model", "prognosis prediction", and "survival prediction" from 1 January 1980 to 5 May 2021. Reference lists from articles were reviewed and relevant articles were identified. Conclusions:The performance of gene-related models has not obviously improved. Relative to the innovation and diversity of predictors, it is more important to establish a highly stable model that is convenient for clinical application. Most of the prevalent models are highly biased and referring to PROBAST at the beginning of the study may be able to significantly control the bias. Existing models should be validated in a large external dataset to make a meaningful comparison.

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“…Assuming that ILA is a precursor to IPF, fibrosis inherent in ILA may have influenced tumor arousal, thus resulting in higher cancer staging and larger tumor size. Squamous cell carcinoma is associated with an adverse prognosis compared with adenocarcinoma 26 . Tumor staging reflects patient outcomes, that is, a higher staging is associated with a worse prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…Squamous cell carcinoma is associated with an adverse prognosis compared with adenocarcinoma. 26 Tumor staging reflects patient outcomes, that is, a higher staging is associated with a worse prognosis. The current study revealed that the presence of ILA is significantly associated with squamous cell carcinoma and higher cancer staging.…”

Section: Discussionmentioning

confidence: 99%

Clinical implication of interstitial lung abnormality in elderly patients with early‐stage non‐small cell lung cancer

et al. 2022

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Background Interstitial lung abnormality (ILA) is closely related to lung cancer. This study aimed to assess whether the presence of ILA is associated with the clinicoradiological features of elderly patients (≥70 years) with early‐stage non‐small cell lung cancer (NSCLC). Methods Elderly patients who underwent surgical resection for stage I or II NSCLC with preserved lung function between 2012 and 2019 were retrospectively identified. ILA was evaluated using a three‐point scale. Univariate analyses were performed for clinicoradiological features based on the presence of ILA. Logistic and linear regression analyses were performed for cancer staging and tumor size, respectively. Results A total of 254 patients were evaluated. The presence of ILA (score = 2) was significantly associated with male sex, current or former smoker status, higher pack‐years of smoking, low forced expiratory volume in one second/forced vital capacity ratios and diffusing capacity of the lung for carbon monoxide, and presence of emphysema (≥5%). Tumor characteristics, such as lower lobe and outer one‐third location, squamous cell carcinoma, and higher cancer stage (stage II) were significantly associated with ILA. The presence of ILA independently predicted a higher cancer stage (adjusted odds ratio, 1.81; 95% confidence interval, 1.10–2.96; p = 0.02) and a larger tumor size in linear regression analysis (p = 0.04). Conclusions Patients with ILA showed clinicoradiological features similar to those of idiopathic pulmonary fibrosis in elderly patients with early‐stage NSCLC. Identifying the clinical implications of ILA in early‐stage lung cancer will guide clinicians in providing appropriate management for these patients.

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A prognostic model for elderly patients with squamous non-small cell lung cancer: a population-based study

Cited by 16 publications

References 37 publications

Construction and validation of prognostic nomograms for elderly patients with metastatic non‐small cell lung cancer

Construction and validation of prognostic nomograms for elderly patients with metastatic non‐small cell lung cancer

A narrative review of prognosis prediction models for non-small cell lung cancer: what kind of predictors should be selected and how to improve models?

Clinical implication of interstitial lung abnormality in elderly patients with early‐stage non‐small cell lung cancer

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