Development and Validation of a Nomogram Prognostic Model for Resected Limited-Stage Small Cell Lung Cancer Patients

Zeng, Qingpeng; Li, Jiagen; Tan, Fengwei; Sun, Nan; Mao, Yousheng; Gao, Yushun; Xue, Qi; Gao, Shugeng; Zhao, Jun; He, Jie

doi:10.1245/s10434-020-09552-w

Cited by 13 publications

(13 citation statements)

References 25 publications

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“…The AUCs of the two predict models from 1 to 5 year were presented and compared in Table S2 . We also compared this nomogram with a previous nomogram with 7 predictors for resected SCLC [ 18 ]. The time-dependent ROC showed this nomogram with less predictors was not inferior to the previous nomogram (Figure S2 ).…”

Section: Resultsmentioning

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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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: Resultsmentioning

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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“…Currently, nomograms have been used for conveniently predicting the outcomes of many kinds of cancers ( 30 – 33 ) which significantly improved the process of individualized medical decision-making. Regarding breast cancer, some previous studies have developed survival predicting models for those with N 3 status, HR-/Her-2-, or IV stage ( 22 , 27 , 29 , 34 ).…”

Section: Discussionmentioning

confidence: 99%

Cancer-Specific Survival Outcome in Early-Stage Young Breast Cancer: Evidence From the SEER Database Analysis

Xiao

et al. 2022

Front. Endocrinol.

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BackgroundYoung women with breast cancer are determined to present poorer survival compare with elderly patients. Therefore, identifying the clinical prognostic factors in young women with early-stage (T1-2N0-1M0) breast cancer is pivotal for surgeons to make better postoperative management.MethodsThe clinicopathological characteristics of female patients with early-stage breast cancer from the Surveillance, Epidemiology, and End Results program between Jan 2010 and Dec 2015 were retrospectively reviewed and analyzed. Univariate and multivariate Cox regression analyses were used to determine the potential risk factors of cancer-specific survival in young women with early-stage breast cancer. The nomogram was constructed and further evaluated by an internal validation cohort. The Kaplan-Meier survival curves were used to estimate cancer-specific survival probability and the cumulative incidence.ResultsSix variables including race, tumor location, grade, regional lymph node status, tumor subtype, and size were identified to be significantly associated with the prognosis of young women with early-stage breast cancer during the postoperative follow-up. A nomogram for predicting the 3-, 5- year cancer-specific survival probability in this subpopulation group was established with a favorable concordance index of 0.783, supported by an internal validation cohort with the AUC of 0.722 and 0.696 in 3-, 5- year cancer-specific survival probability, respectively.ConclusionsThe first predictive nomogram containing favorable discrimination is successfully established and validated for predicting the 3-, 5- year cancer-specific survival probability in young women with early-stage breast cancer during the postoperative follow-up. This model would help clinicians to make accurate treatment decisions in different clinical risk population.

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“…This study highlighted the importance of performing lobectomy for resectable C-SCLC patients. Pan et al and Zeng et al also confirmed that surgical removal of the primary lesion in patients with SCLC is safe and effective, even when a larger extent of resection is necessary [20,21].…”

Section: Description Of the State Of Knowledgementioning

confidence: 87%

“…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 Nomogram Prognostic Model for Resected Limited-Stage Small Cell Lung Cancer Patients

Cited by 13 publications

References 25 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

Cancer-Specific Survival Outcome in Early-Stage Young Breast Cancer: Evidence From the SEER Database Analysis

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

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