The Positive Lymph Node Ratio Predicts Survival in T1−4N1−3M0 Non-Small Cell Lung Cancer: A Nomogram Using the SEER Database
Background: An increasing number of studies have shown that the positive lymph node ratio (pLNR) can be used to evaluate the prognosis of non-small cell lung cancer (NSCLC) patients. To determine the predictive value of the pLNR, we collected data from the Surveillance, Epidemiology, and End Results...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-08-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fonc.2020.01356/full |
| _version_ | 1818143523761815552 |
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| author | Yi Liao Yi Liao Guofang Yin Guofang Yin Xianming Fan Xianming Fan |
| author_facet | Yi Liao Yi Liao Guofang Yin Guofang Yin Xianming Fan Xianming Fan |
| author_sort | Yi Liao |
| collection | DOAJ |
| description | Background: An increasing number of studies have shown that the positive lymph node ratio (pLNR) can be used to evaluate the prognosis of non-small cell lung cancer (NSCLC) patients. To determine the predictive value of the pLNR, we collected data from the Surveillance, Epidemiology, and End Results (SEER) database and performed a retrospective analysis.Methods: We collected survival and clinical information on patients with T1−4N1−3M0 NSCLC diagnosed between 2010 and 2016 from the SEER database and screened them according to inclusion and exclusion criteria. X-tile software was used to obtain the best cut-off value for the pLNR. Then, we randomly divided patients into a training set and a validation set at a ratio of 7:3. Pearson's correlation coefficient, tolerance and the variance inflation factor (VIF) were used to detect collinearity between variables. Univariate and multivariate Cox regression analyses were used to identify significant prognostic factors, and nomograms was constructed to visualize the results. The concordance index (C-index), calibration curves, and decision curve analysis (DCA) were used to assess the predictive ability of the nomogram. We divided the patient scores into four groups according to the interquartile interval and constructed a survival curve using Kaplan–Meier analysis.Results: A total of 6,245 patients were initially enrolled. The best cut-off value for the pLNR was determined to be 0.55. The nomogram contained 13 prognostic factors, including the pLNR. The pLNR was identified as an independent prognostic factor for both overall survival (OS) and cancer-specific survival (CSS). The C-index was 0.703 (95% CI, 0.695–0.711) in the training set and 0.711 (95% CI, 0.699–0.723) in the validation set. The calibration curves and DCA also indicated the good predictability of the nomogram. Risk stratification revealed a statistically significant difference among the four groups of patients divided according to quartiles of risk score.Conclusion: The nomogram containing the pLNR can accurately predict survival in patients with T1−4N1−3M0 NSCLC. |
| first_indexed | 2024-12-11T11:33:02Z |
| format | Article |
| id | doaj.art-48a9a13e85a545cdb50b79418c832d8d |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-11T11:33:02Z |
| publishDate | 2020-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-48a9a13e85a545cdb50b79418c832d8d2022-12-22T01:08:50ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-08-011010.3389/fonc.2020.01356524243The Positive Lymph Node Ratio Predicts Survival in T1−4N1−3M0 Non-Small Cell Lung Cancer: A Nomogram Using the SEER DatabaseYi Liao0Yi Liao1Guofang Yin2Guofang Yin3Xianming Fan4Xianming Fan5Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, ChinaInflammation & Allergic Diseases Research Unit, The Affiliated Hospital of Southwest Medical University, Luzhou, ChinaDepartment of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, ChinaInflammation & Allergic Diseases Research Unit, The Affiliated Hospital of Southwest Medical University, Luzhou, ChinaDepartment of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, ChinaInflammation & Allergic Diseases Research Unit, The Affiliated Hospital of Southwest Medical University, Luzhou, ChinaBackground: An increasing number of studies have shown that the positive lymph node ratio (pLNR) can be used to evaluate the prognosis of non-small cell lung cancer (NSCLC) patients. To determine the predictive value of the pLNR, we collected data from the Surveillance, Epidemiology, and End Results (SEER) database and performed a retrospective analysis.Methods: We collected survival and clinical information on patients with T1−4N1−3M0 NSCLC diagnosed between 2010 and 2016 from the SEER database and screened them according to inclusion and exclusion criteria. X-tile software was used to obtain the best cut-off value for the pLNR. Then, we randomly divided patients into a training set and a validation set at a ratio of 7:3. Pearson's correlation coefficient, tolerance and the variance inflation factor (VIF) were used to detect collinearity between variables. Univariate and multivariate Cox regression analyses were used to identify significant prognostic factors, and nomograms was constructed to visualize the results. The concordance index (C-index), calibration curves, and decision curve analysis (DCA) were used to assess the predictive ability of the nomogram. We divided the patient scores into four groups according to the interquartile interval and constructed a survival curve using Kaplan–Meier analysis.Results: A total of 6,245 patients were initially enrolled. The best cut-off value for the pLNR was determined to be 0.55. The nomogram contained 13 prognostic factors, including the pLNR. The pLNR was identified as an independent prognostic factor for both overall survival (OS) and cancer-specific survival (CSS). The C-index was 0.703 (95% CI, 0.695–0.711) in the training set and 0.711 (95% CI, 0.699–0.723) in the validation set. The calibration curves and DCA also indicated the good predictability of the nomogram. Risk stratification revealed a statistically significant difference among the four groups of patients divided according to quartiles of risk score.Conclusion: The nomogram containing the pLNR can accurately predict survival in patients with T1−4N1−3M0 NSCLC.https://www.frontiersin.org/article/10.3389/fonc.2020.01356/fullnomogrampositive lymph nodenon-small cell lung cancerSEERprognosis |
| spellingShingle | Yi Liao Yi Liao Guofang Yin Guofang Yin Xianming Fan Xianming Fan The Positive Lymph Node Ratio Predicts Survival in T1−4N1−3M0 Non-Small Cell Lung Cancer: A Nomogram Using the SEER Database Frontiers in Oncology nomogram positive lymph node non-small cell lung cancer SEER prognosis |
| title | The Positive Lymph Node Ratio Predicts Survival in T1−4N1−3M0 Non-Small Cell Lung Cancer: A Nomogram Using the SEER Database |
| title_full | The Positive Lymph Node Ratio Predicts Survival in T1−4N1−3M0 Non-Small Cell Lung Cancer: A Nomogram Using the SEER Database |
| title_fullStr | The Positive Lymph Node Ratio Predicts Survival in T1−4N1−3M0 Non-Small Cell Lung Cancer: A Nomogram Using the SEER Database |
| title_full_unstemmed | The Positive Lymph Node Ratio Predicts Survival in T1−4N1−3M0 Non-Small Cell Lung Cancer: A Nomogram Using the SEER Database |
| title_short | The Positive Lymph Node Ratio Predicts Survival in T1−4N1−3M0 Non-Small Cell Lung Cancer: A Nomogram Using the SEER Database |
| title_sort | positive lymph node ratio predicts survival in t1 4n1 3m0 non small cell lung cancer a nomogram using the seer database |
| topic | nomogram positive lymph node non-small cell lung cancer SEER prognosis |
| url | https://www.frontiersin.org/article/10.3389/fonc.2020.01356/full |
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