The Construction and Validation of Nomogram to Predict the Prognosis with Small-Cell Lung Cancer Followed Surgery

Abstract

This study constructed and validated a prognostic model to evaluate the survival of small-cell lung cancer (SCLC) patients following surgery, and shed light on the strategy of postoperative radiotherapy. A total of 882 patients from Shanghai Pulmonary Hospital and the Surveillance, Epidemiology and End Results database after lung resection were selected. Multivariable Cox analysis was used to identify the indicators affecting long-term survival in patients. A nomogram was constructed to predict the prognosis of eligible patients. Indices of concordance (C-index) was used to access the predictive ability of cancer-specific survival (CSS) for the prognostic model. CSS discrimination in the prognostic model was comparable in the training and validation cohorts (C-index = 0.637[NORAD-T], 0.660[NORAD-V], 0.656[RAD] and 0.627[our hospital], respectively. Stratification based on the cutoff value of the nomogram yielded low- and high-risk subgroups in four cohorts. For patients in the high-risk group, postoperative radiotherapy was considered a survival-promoting strategy (unadjusted HR 0.641, 95% CI 0.469–0.876, p = 0.0046). In the low-risk group, however, the implementation of radiotherapy barely had an influence on CSS. In conclusion, the nomogram we constructed and validated could predict the prognosis of SCLC patients followed surgery and identify high-risk patients who were likely to benefit from postoperative radiotherapy.

Construction and validation of a nomogram based on the log odds of positive lymph nodes to predict cancer-specific survival in patients with small cell lung cancer after surgery

“…A novel prognostic nomogram was generated based on the LODDS status for SCLC patients. Many researchers have focused on the construction of a prognostic evaluation for SCLC and have built nomograms related to it [ 21 , 22 , 29 , 30 , 36 , 37 ]. The majority of them have been used to predict the entire pan-stage of SCLC patients.…”

“…In addition, some researchers have built nomograms to predict long-term survival of particular patient groups, including SCLC patients with metastasis and combined SCLC patients [ 38 , 39 ]. To evaluate the efficacy of different treatments, nomograms can also be established to evaluate the survival of SCLC patients after radiotherapy, chemotherapy, or surgery [ 37 , 40 , 41 ]. So far, there have been three nomograms built to predict the overall survival of SCLC patients after surgery, where LODDS was not calculated and incorporated into the models.…”

Construction and validation of a nomogram to predict the overall survival of small cell lung cancer: a multicenter retrospective study in Shandong province, China

“…Nomograms have been shown to be effective predictive tools for assessing patient prognosis [ 19 – 21 ]. In the case of SCLC, most prognostic models have been constructed using data from public databases or hospital medical record systems [ 11 – 14 ]. Liang et al [ 8 ] developed two SCLC nomograms for limited and extensive staging using the SEER database, and the models both outperformed the 8th TNM staging system.…”

“…SCLC is characterized by an abbreviated tumor doubling time, metastasis at an early stage, poor prognosis, and more than half of the patients are diagnosed at an advanced stage, so it is necessary to design a risk model that can predict the overall survival (OS) prognosis of patients [ 10 ]. Presently existing prognostic models for SCLC are delimited to either public databases or the confines of singular-center hospitals [ 11 – 14 ]. Their predictive capabilities exhibit inconsistent performance, and a substantial portion remains devoid of external validation.…”

Construction and validation of a prognostic nomogram model for SCLC patients in Shandong Province, China

“…Nomograms have been shown to be effective predictive tools for assessing patient prognosis [16][17][18] . In the case of SCLC, most prognostic models have been constructed using data from public databases or hospital medical record systems [19][20][21][22] . For example, Liang et al [11] developed a restricted-stage and extensive-stage SCLC nomogram using the SEER database, which was found to be more effective than stage 8 TNM.…”