Development and validation of a prognostic model of resectable small-cell lung cancer: a large population-based cohort study and external validation

Wang, Yu; Pang, Zhaofei; Chen, Xiaowei; Yan, Tao; Liu, Jichang; Du, Jiajun

doi:10.1186/s12967-020-02412-x

Cited by 17 publications

(34 citation statements)

References 28 publications

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“…An etoposide and cisplatin regimen with concurrent radiation is recommended as standard treatment for LD-SCLC and was shown to enhance survival and was well tolerated [ 23 , 35 – 37 ]. Although chemotherapy was associated with longer survival in our analysis, the impact was not statistically significant, which is contrary to previous reports [ 25 , 38 ]. This may be due to relatively small number of patients who did not receive chemotherapy.…”

Section: Discussioncontrasting

confidence: 99%

“…This may be due to the smaller tumor size in sublobectomy compared to lobectomy and pneumonectomy (median, 18 vs. 27.5 vs. 42 mm; p < 0.001). Lymph node status is closely related to surgical outcome, and several studies have also shown that lymph node metastasis predicts surgical outcome in SCLC [ 5 , 38 ]. Thus, mediastinal lymph node dissection should be performed in surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

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Effect of surgery on survival in patients with stage III N2 small cell lung cancer: propensity score matching analysis and nomogram development and validation

Chai

Feng

et al. 2021

World J Surg Onc

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Background The standard treatment of stage III N2 small cell lung cancer (SCLC) is concurrent chemoradiation, and surgery is not recommended. This study was aimed to evaluate whether surgery has survival benefits in patients with stage III N2 SCLC and investigate the factors influencing survival of surgery. Methods Patients diagnosed with stage T1-4N2M0 SCLC from 2004 to 2015 were selected from the Surveillance Epidemiology End Results database. Propensity score matching (PSM) was used to balance confounders between patients who underwent surgery and those treated with radiation and/or chemotherapy. We compared overall survival (OS) of the two groups using Kaplan-Meier curves and a Cox proportional hazard model. We also identified prognostic factors in patients with surgical resection, and a nomogram was developed and validated for predicting postoperative OS. Results −A total of 5576 patients were included in the analysis; of these, 211 patients underwent surgery. PSM balanced the differences between the two groups. The median OS was longer in the surgery group than in the non-surgery group (20 vs. 15 months; p = 0.0024). Surgery was an independent prognostic factor for longer OS in the multivariate Cox regression analysis, and subgroup analysis revealed a higher survival rate in T1 stage patients treated with surgery (hazard ratio = 0.565, 95% confidence interval: 0.401–0.798; p = 0.001). In patients who underwent surgery, four prognostic factors, including age, T stage, number of positive lymph nodes, and radiation, were selected into nomogram development for predicting postoperative OS. C-index, decision curve analyses, integrated discrimination improvement, and time-dependent receiver operating characteristics showed better performance in nomogram than in the tumor-node-metastasis staging system. Calibration plots demonstrated good consistency between nomogram predicted survival and actual observed survival. The patients were stratified into three different risk groups by prognostic scores and Kaplan-Meier curves showed significant difference between these groups. Conclusions These results indicate that surgery can prolong survival in patients with operable stage III N2 SCLC, particularly those with T1 disease. A nomogram that includes age, T stage, number of positive lymph nodes, and radiation can be used to predict their long-term postoperative survival.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effect of surgery on survival in patients with stage III N2 small cell lung cancer: propensity score matching analysis and nomogram development and validation

Chai

Feng

et al. 2021

World J Surg Onc

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“…For example, the effects of additional tumor factors have not been taken into account [ 10 ]. Nomogram, as a practical application tool, makes an individual prediction by quantifying risk factors into scores and shows more accurate and useful than the AJCC-TNM staging system in a variety of cancers [ 11 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…For example, the effects of additional tumor factors have not been taken into account [10]. Nomogram, as a practical application tool, makes an [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Prognostic Nomograms for Nonelderly Adults with Gastric Signet Ring Cell Carcinoma

Wang

Yao

Huang

et al. 2021

BioMed Research International

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Background. Nomograms were established to predict the survival for gastric signet ring cell carcinoma (GSRC) in young and middle-aged adults. Material and Methods. Eligible patients with GSRC from 2004 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database and then divided into a training and a testing cohort in proportion. Independent prognostic factors were picked by univariate and multivariate Cox regression analysis to set up nomograms. The predictive effect and clinical value of nomograms were evaluated by the concordance index (C-index), calibration curves, and receiver operating characteristic curve (ROC). Results. A total of 1686 GSRC patients were subsumed into this case for analysis, including a training ( n = 1180 ) and a testing cohort ( n = 506 ). Independent risk factors related to overall survival (OS) and cancer-specific survival (CSS) comprised of race, TNM stage, tumor size, number of positive lymph nodes (PLNE), and chemotherapy. For OS, the C-indexes of the training and testing cohorts were 0.737 and 0.752, while for CSS, C-indexes were, respectively, 0.749 and 0.751. These revealed that nomograms accurately predicted OS and CSS. Calibration curves and ROC demonstrated the apparent superiority of nomograms. Conclusion. We built a well-understood and comprehensive prognostic assessment model for GSRC, which provided an individualized survival prediction in the form of a quantitative score that can be considered for clinical practice.

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“…Of these, only manuscrpits dealing directly with surgical pulmonary resection in SCLC were selected. Based on these criteria, 14 publications were identified and included in the review [8][9][10][11][12][13][14][15][16][17][18][19][20][21](Tab. 1).…”

Section: Review Methodsmentioning

confidence: 99%

The role of pulmonary resection in early stage small cell lung cancer

Sagan¹,

Galek²,

Prystupa³

2021

J Pre Clin Clin Res.

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Introduction and Objective. For many decades, small-Cell Lung Cancer (SCLC) has been considered a non-surgical disease and is traditionally managed by chemo-and radiotherapy. However, recent advances in early detection of pulmonary lesions have made it possible to detect small cell lung cancer at a very early stage of development. The aim of this review was to assess the current state of knowledge on the role of surgical pulmonary resection in patients with early stage SCLC, and to determine the optimal diagnostic and therapeutic strategy for patients with pulmonary nodules suspected for SCLC. Review Methods. A literature search of the PubMed database was conducted using the key words: 'small cell lung cancer pulmonary resection not[non]' in the last 5 years. 99 manuscripts were found. Of these, only dealing directly with surgical pulmonary resection in SCLC were selected. Based on these criteria, 14 publications were identified and included in the review. Brief description of the state of knowledge. Current scientific and clinical data reveal that surgical resection offers patients with SCLC considerable therapeutic benefits with favourably high overall survival rates. Analyzed reports showed that the local relapse rate in patients after surgical resection was significantly lower than in the non-surgical group. Furthermore, definitive surgical resection with adjuvant chemotherapy resulted in improved survival for patients with early stage SCLC, when compared to conservative approach. Summary. Pulmonary resection of an early stage SCLC as a component of combined treatment offers considerable therapeutic benefits, among which almost 100% local control is of the greatest importance. Up-to-date clinical strategies strongly support the recommendation that peripheral pulmonary lesions suspected to be malign, should be surgically resected, unless serious contraindications are indicated.

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Development and validation of a prognostic model of resectable small-cell lung cancer: a large population-based cohort study and external validation

Cited by 17 publications

References 28 publications

Effect of surgery on survival in patients with stage III N2 small cell lung cancer: propensity score matching analysis and nomogram development and validation

Effect of surgery on survival in patients with stage III N2 small cell lung cancer: propensity score matching analysis and nomogram development and validation

Prognostic Nomograms for Nonelderly Adults with Gastric Signet Ring Cell Carcinoma

The role of pulmonary resection in early stage small cell lung cancer

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