Nomogram to Predict Cancer Specific Survival in Patients with Pathological Stage IA Non-small Cell Lung Cancer

Cai, Jing-Sheng; Dou, Xiao-Meng; Li, Jibin; Yang, Mu-Zi; Xie, Chu-Long; Hou, Xue; Yang, Hao‐Xian

doi:10.1053/j.semtcvs.2021.06.023

Cited by 9 publications

(7 citation statements)

References 30 publications

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“…Of those, 40 (24.5%) had received surgery plus adjuvant treatment and 123 (75.5%) surgery alone. The possibility of identifying patients with high-risk for recurrence following surgical resection can help with surveillance plans and potentially personalize adjuvant therapy for these patients (28)(29)(30).…”

Section: Discussionmentioning

confidence: 99%

Clinical factors influencing long-term survival in a real-life cohort of early stage non-small-cell lung cancer patients in Spain

Torrente

Sousa²,

Guerreiro³

et al. 2023

Front. Oncol.

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BackgroundCurrent prognosis in oncology is reduced to the tumour stage and performance status, leaving out many other factors that may impact the patient´s management. Prognostic stratification of early stage non-small-cell lung cancer (NSCLC) patients with poor prognosis after surgery is of considerable clinical relevance. The objective of this study was to identify clinical factors associated with long-term overall survival in a real-life cohort of patients with stage I-II NSCLC and develop a prognostic model that identifies features associated with poor prognosis and stratifies patients by risk.MethodsThis is a cohort study including 505 patients, diagnosed with stage I-II NSCLC, who underwent curative surgical procedures at a tertiary hospital in Madrid, Spain.ResultsMedian OS (in months) was 63.7 (95% CI, 58.7-68.7) for the whole cohort, 62.4 in patients submitted to surgery and 65 in patients submitted to surgery and adjuvant treatment. The univariate analysis estimated that a female diagnosed with NSCLC has a 0.967 (95% CI 0.936 - 0.999) probability of survival one year after diagnosis and a 0.784 (95% CI 0.712 - 0.863) five years after diagnosis. For males, these probabilities drop to 0.904 (95% CI 0.875 - 0.934) and 0.613 (95% CI 0.566 - 0.665), respectively. Multivariable analysis shows that sex, age at diagnosis, type of treatment, ECOG-PS, and stage are statistically significant variables (p<0.10). According to the Cox regression model, age over 50, ECOG-PS 1 or 2, and stage ll are risk factors for survival (HR>1) while adjuvant chemotherapy is a good prognostic variable (HR<1). The prognostic model identified a high-risk profile defined by males over 71 years old, former smokers, treated with surgery, ECOG-PS 2.ConclusionsThe results of the present study found that, overall, adjuvant chemotherapy was associated with the best long-term OS in patients with resected NSCLC. Age, stage and ECOG-PS were also significant factors to take into account when making decisions regarding adjuvant therapy.

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Section: Discussionmentioning

confidence: 99%

Clinical factors influencing long-term survival in a real-life cohort of early stage non-small-cell lung cancer patients in Spain

Torrente

Sousa²,

Guerreiro³

et al. 2023

Front. Oncol.

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“…Previously, many researches has been focused on the validations and refinements of the current 8th edition of the NSCLC TNM stage classification 10–14 . To date, there was no validation study focused on the T category of the NSCLC patients with bronchus involvements.…”

Section: Discussionmentioning

confidence: 99%

Investigation of the non‐small cell lung cancer patients with bronchus involvements: A population‐based study

Wang,

Ye,

Xie

et al. 2023

Clinical Respiratory J

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BackgroundWe aimed to explore the prognostic differences among T1‐4N0‐2M0 non‐small cell lung cancer (NSCLC) patients with bronchus involvements and to validate the T category of these patients in an external cohort.MethodsUnivariable and multivariable Cox analysis was performed to determine the prognostic factors. Kaplan–Meier method with a log‐rank test was used to compare overall survival differences between groups. Propensity score matching method was used to minimize the bias caused by the imbalanced covariates between groups.ResultsA total of 169 390 eligible T1‐4N0‐2M0 NSCLC cases were included. There were 2354, 3367, 1638, 75, 87 585, 42 056, 19 246, and 13 069 cases in the group of superficial tumors of any size with invasive component limited to bronchial wall (T1‐bronchus), tumors involving main stem bronchus ≥2 cm from carina (T2‐main bronchus [≥2 cm]), tumors involving main stem bronchus <2 cm from carina (T2‐main bronchus [<2 cm]), tumors with carina invasion (T4‐carina), T1, T2, T3, and T4, respectively. Multivariable Cox analysis indicated that T1‐bronchus patients had the best prognosis; T2‐main bronchus (≥2 cm) and T2‐main bronchus (<2 cm) patients had similar prognosis both in the entire cohort and in several subgroups. Survival curves showed that T1‐bronchus and T1 patients had similar survival rates; the survivals of T2‐main bronchus patients regardless of the distance from carina were comparable to those of T2 patients, and the survivals of T4‐carina patients were also similar to those of T4 patients.ConclusionsOur results validated and supported the current T category for the patients with bronchus involvements, which might provide certain reference value for the revisions of T category in the next version of the tumor‐node‐metastasis stage classification.

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“…Finally, a nomogram was established. As is known that nomogram is a widely used and efficient tool for predicting prognosis in malignancies such as breast cancer [ 18 ], gastric cancer [ 19 ], esophageal carcinoma [ 20 ], and lung cancer [ 21 , 22 , 23 ]. The C-index of our nomogram was little pale (only 0.65).…”

Section: Discussionmentioning

confidence: 99%

Occult Non-Small Cell Lung Cancer: An Underappreciated Disease

Cai

Yang

Wang

2022

JCM

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Background: The number of researches on occult non-small cell lung cancer (NSCLC) is modest. Herein, we defined the clinicopathological features, prognosis and survival outcome of this underappreciated tumor, with purpose of obtaining a clearer picture on this disease. Methods: The entire cohort was categorized into two groups (occult NSCLC and other NSCLC) and further into five groups (occult, T1, T2, T3 and T4). A least absolute shrinkage and selection operator (LASSO) penalized Cox regression model was performed to identify the prognostic indicators. A nomogram and a risk-classifying system were formulated. Kaplan–Meier with Log-rank method was carried out to compare overall survival (OS) and cancer specific survival (CSS) differences between groups. Results: 59,046 eligible NSCLC cases (occult NSCLC: 1158 cases; other NSCLC: 57,888 cases) were included. Occult NSCLC accounted for 2.0% of the included cases. Multivariate analysis revealed that age, sex, tumor location, histology, grade and surgery were prognostic factors for OS. The corresponding prognostic nomogram classified occult NSCLC patients into low-risk and high-risk group, and its performance was acceptable. Survival curves demonstrated that occult NSCLC patients exhibited worse survivals than other NSCLC. In further analyses, the survival of low-risk occult NSCLC and stage T3 NSCLC were comparable, and the high-risk occult NSCLC patients still owned the worst survival rate. Conclusions: Occult NSCLC was an aggressive tumor with poor prognosis, and surgery was the preferred treatment. More attention should be paid to this overlooked disease due to no evidence of tumor imaging.

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Nomogram to Predict Cancer Specific Survival in Patients with Pathological Stage IA Non-small Cell Lung Cancer

Cited by 9 publications

References 30 publications

Clinical factors influencing long-term survival in a real-life cohort of early stage non-small-cell lung cancer patients in Spain

Clinical factors influencing long-term survival in a real-life cohort of early stage non-small-cell lung cancer patients in Spain

Investigation of the non‐small cell lung cancer patients with bronchus involvements: A population‐based study

Occult Non-Small Cell Lung Cancer: An Underappreciated Disease

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