Nomograms for Predicting Overall and Recurrence-free Survival From Pathologic Stage IA and IB Lung Cancer After Lobectomy

Merritt, Robert E.; Abdel-Rasoul, Mahmoud; Fitzgerald, Morgan; D’Souza, Desmond M.; Kneuertz, Peter J.

doi:10.1016/j.cllc.2020.10.009

Cited by 20 publications

(18 citation statements)

References 22 publications

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“…Furthermore, validation of the model we established was accomplished by bootstrap resampling. Although previous studies have successfully reported nomograms to predict the postoperative survival and recurrence in stage IA NSCLC, they didn’t include inflammatory biomarkers ( 7 , 56 – 59 ). To our knowledge, this study is the first large cohort study to create a nomogram combining inflammatory biomarkers and other clinicopathological factors to predict CSS and DFS probability in stage I adenocarcinoma patients.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Inflammatory Biomarkers in Patients With Stage I Lung Adenocarcinoma Treated With Surgical Dissection

et al. 2021

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ObjectiveInflammation plays a crucial role in tumorigenesis and progression. Our purpose was to investigate the prognostic value of neutrophil-to-lymphocyte ratio (NLR), systemic inflammation response index (SIRI) and systemic immune-inflammation index (SII), and develop a nomogram to predict the cancer-specific survival (CSS) and disease-free survival (DFS) of stage I lung adenocarcinoma patients.Methods1431 patients undergoing surgical resection with pathologically confirmed stage I lung adenocarcinoma were reviewed. The optimal cut-off values for NLR, SII, and SIRI were defined by the receiver operating characteristic (ROC) curve. Cox proportional hazards regression analyses were performed to recognize factors significantly correlated with CSS and DFS to construct the nomogram. The value of adjuvant chemotherapy on model-defined high-risk and low-risk patients was further explored.ResultsThe cohort had a median follow-up time of 63 months. Multivariate analysis revealed that higher NLR (≥2.606), higher SIRI (≥0.705), higher SII (≥580.671), later T stage, histological pattern with solid or micropapillary components and radiologic features with solid nodules were significantly associated with worse CSS and DFS. The concordance index (C-index) of the nomogram established by all these factors was higher than that of the TNM staging system both in CSS (validation set 0.778 vs 0.652) and DFS (validation set 0.758 vs 0.695). Furthermore, the value of the established nomogram on risk stratification in stage I lung adenocarcinoma patients was validated.ConclusionsHigher NLR, SII and SIRI pretreatment were associated with worse survival outcomes. A practical nomogram based on these three inflammatory biomarkers may help clinicians to precisely stratify stage I lung adenocarcinoma patients into high- and low-risk and implement individualized treatment.

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Section: Discussionmentioning

confidence: 99%

Prognostic Value of Inflammatory Biomarkers in Patients With Stage I Lung Adenocarcinoma Treated With Surgical Dissection

et al. 2021

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“…However, adopting the TNM staging system cannot accurately partition the prognosis of stage IA IAC. Previous studies have developed prognostic models including sex, age, operative approach, examined lymph nodes, vascular invasion, and EGFR gene mutation for stage IA NSCLC but ignored GGO components and LUAD subtypes ( Merritt et al, 2020 ; Yang et al, 2020 ; Cai et al, 2021 ). To our knowledge, this study is the first to develop a prognostic nomogram based on GGO component and LUAD subtype for patients undergoing radical resection in pathological stage IA IAC, and our nomograms showed satisfactory predictive performance with an excellent Harrell’s C-index for DFS (0.667; 95% CI 0.586–0.748) and OS (0.866; 95% CI 0.841–0.891).…”

Section: Discussionmentioning

confidence: 99%

“…Although prognostic nomograms including sex, age, operative approach, examined lymph nodes, vascular invasion, and EGFR gene mutation for stage IA NSCLC have been developed ( Merritt et al, 2020 ; Yang et al, 2020 ; Cai et al, 2021 ), a prognostic model based on LUAD subtype and GGO component especially designed for stage IA IAC has been lacking. Recently, researchers have focused on the relationship between GGO component and LUAD subtypes as well as the differential gene mutation profiles among different LUAD subtypes and CT characteristics ( Gao et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Prognostic Nomograms Based on Ground Glass Opacity and Subtype of Lung Adenocarcinoma for Patients with Pathological Stage IA Lung Adenocarcinoma

Zhai

Liang

Duan

et al. 2021

Front. Cell Dev. Biol.

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The value of lung adenocarcinoma (LUAD) subtypes and ground glass opacity (GGO) in pathological stage IA invasive adenocarcinoma (IAC) has been poorly understood, and reports of their association with each other have been limited. In the current study, we retrospectively reviewed 484 patients with pathological stage IA invasive adenocarcinoma (IAC) at Sun Yat-sen University Cancer Center from March 2011 to August 2018. Patients with at least 5% solid or micropapillary presence were categorized as high-risk subtypes. Independent indicators for disease-free survival (DFS) and overall survival (OS) were identified by multivariate Cox regression analysis. Based on these indicators, we developed prognostic nomograms of OS and DFS. The predictive performance of the two nomograms were assessed by calibration plots. A total of 412 patients were recognized as having the low-risk subtype, and 359 patients had a GGO. Patients with the low-risk subtype had a high rate of GGO nodules (p < 0.001). Multivariate Cox regression analysis showed that the high-risk subtype and GGO components were independent prognostic factors for OS (LUAD subtype: p = 0.002; HR 3.624; 95% CI 1.263–10.397; GGO component: p = 0.001; HR 3.186; 95% CI 1.155–8.792) and DFS (LUAD subtype: p = 0.001; HR 2.284; 95% CI 1.448–5.509; GGO component: p = 0.003; HR 1.877; 95% CI 1.013–3.476). The C-indices of the nomogram based on the LUAD subtype and GGO components to predict OS and DFS were 0.866 (95% CI 0.841–0.891) and 0.667 (95% CI 0.586–0.748), respectively. Therefore, the high-risk subtype and GGO components were potential prognostic biomarkers for patients with stage IA IAC, and prognostic models based on these indicators showed good predictive performance and satisfactory agreement between observational and predicted survival.

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“…(9). Previous studies also show the risk factors of recurrence in IB NSCLC patients are histology, smoking history and LVI (10). In this study, we put more indicators into consideration to predict the recurrence of IB NSCLC, such as elevated preoperative serum carcinoembryonic antigen, which is one of most commonly used marker to evaluate the prognosis of cancer (11).…”

Section: Introductionmentioning

confidence: 96%

A nomogram to predict the recurrence-free survival and analyze the utility of chemotherapy in stage IB non-small cell lung cancer

Zhang¹,

Xie²,

Cai³

et al. 2022

Transl Lung Cancer Res

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Background: Large part of patients of stage IB non-small cell lung cancer (IB NSCLC) may suffer recurrence after surgery. This study is to determine risk factors and establish a nomogram for postoperative recurrence and to provide a reference for adjuvant chemotherapy selection in patients with stage IB NSCLC.Methods: A total of 394 patients with postoperative stage IB NSCLC who visited Fujian Medical University Union Hospital between January 2010 and June 2016 were selected. Patients were divided into training and validation cohorts based on the time of diagnosis. Independent risk factors were identified using a Cox proportional hazards regression model. A nomogram was created to predict recurrence-free survival (RFS) and was validated with an independent cohort. The predictive ability of the nomogram was evaluated using the concordance index (C-index) and calibration curve. RFS between the high-and low-risk groups was determined using Kaplan-Meier curves, and subgroup analysis of chemotherapy was performed.Results: Visceral pleura invasion, micropapillary structures, tumor size, preoperative serum carcinoembryonic antigen (CEA) level, preoperative serum cytokeratin-19 fragments (Cyfra21-1) level, and postoperative histology were identified as independent risk factors for stage IB NSCLC recurrence. Discrimination of the nomogram showed good prognostic accuracy and clinical applicability, with a C-index of 0.827 and 0.866 in the training and validation cohorts, respectively. The difference in RFS between the high-and low-risk groups in both cohorts was significant (P<0.05). Finally, a significant difference was observed on whether high-risk group should accept postoperative chemotherapy (P<0.05).Conclusions: This nomogram can predict postoperative recurrence probability in patients with stage IB NSCLC, and can select patients with risk factors who need adjuvant chemotherapy.

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Nomograms for Predicting Overall and Recurrence-free Survival From Pathologic Stage IA and IB Lung Cancer After Lobectomy

Cited by 20 publications

References 22 publications

Prognostic Value of Inflammatory Biomarkers in Patients With Stage I Lung Adenocarcinoma Treated With Surgical Dissection

Prognostic Value of Inflammatory Biomarkers in Patients With Stage I Lung Adenocarcinoma Treated With Surgical Dissection

Prognostic Nomograms Based on Ground Glass Opacity and Subtype of Lung Adenocarcinoma for Patients with Pathological Stage IA Lung Adenocarcinoma

A nomogram to predict the recurrence-free survival and analyze the utility of chemotherapy in stage IB non-small cell lung cancer

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