Establishment and Validation of a Predictive Nomogram for Postoperative Survival of Stage I Non-Small Cell Lung Cancer

Zhi-Hui Wang,1 Lili Deng2 1Department of Medical Oncology, The Fifth People’s Hospital of Shenyang, Shenyang, People’s Republic of China; 2Department of Medical Oncology, The Second Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of ChinaCorrespondence: Lili Deng, Departm...

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Main Authors: Wang ZH, Deng L
Format: Article
Language:English
Published: Dove Medical Press 2022-09-01
Series:International Journal of General Medicine
Subjects:
Online Access:https://www.dovepress.com/establishment-and-validation-of-a-predictive-nomogram-for-postoperativ-peer-reviewed-fulltext-article-IJGM
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author Wang ZH
Deng L
author_facet Wang ZH
Deng L
author_sort Wang ZH
collection DOAJ
description Zhi-Hui Wang,1 Lili Deng2 1Department of Medical Oncology, The Fifth People’s Hospital of Shenyang, Shenyang, People’s Republic of China; 2Department of Medical Oncology, The Second Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of ChinaCorrespondence: Lili Deng, Department of Medical Oncology, The Second Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China, Email dengdoctor@126.comBackground: Surgical procedure is the preferred option for people with early-stage non-small cell lung cancer (NSCLC), while nearly 30% of patients experienced metastatic or recurrent tumor after operation. The primary intention of this context is to summarize high-risk prognostic factors and set up a novel nomogram to predict the overall survival of individuals with stage I NSCLC after resection.Methods: Research objects, 10,218 patients with stage I NSCLC after operation from 2010 to 2015, were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Independent prognostic factors, confirmed by Cox regression analyses, were integrated into a nomogram, to predict the 3-and 5-year overall survival of these individuals. The model experienced internal validation of testing cohorts above and external validation crewed by 160 patients from China. Finally, the nomogram was evaluated through several verification methods such as concordance index (C-index), calibration plots and receiver operating characteristic curve (ROC).Results: Multivariate analysis identified that age, gender, histologic type, differentiation class, type of operation, T stage and treatment were significant predictive factors for the survival of stage I NSCLC. Based on these factors, a nomogram was constructed to predict the 3- and 5-year overall survival of these individuals. Meanwhile, in the training set, this nomogram displayed excellent superiority over the TNM staging system with abroad application, especially in C-index (0.669 vs 0.580) and the AUC (the Area Under ROC Curve) for the 3- and 5-year survival (0.678 vs 0.582; 0.650 vs 0.576). In the calibration curve, the curve representing predicted survival tended to align with the line representing actual survival as well.Conclusion: A nomogram was successfully created and verified to achieve the goal that made a rounded accurate prediction on the survival of postoperative I NSCLC patients in terms of the SEER database.Keywords: NSCLC, nomogram, prognosis, SEER, survival
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spelling doaj.art-6bab4b7e676246bfbcd2154ef1fbf7812022-12-22T04:03:15ZengDove Medical PressInternational Journal of General Medicine1178-70742022-09-01Volume 157287729878217Establishment and Validation of a Predictive Nomogram for Postoperative Survival of Stage I Non-Small Cell Lung CancerWang ZHDeng LZhi-Hui Wang,1 Lili Deng2 1Department of Medical Oncology, The Fifth People’s Hospital of Shenyang, Shenyang, People’s Republic of China; 2Department of Medical Oncology, The Second Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of ChinaCorrespondence: Lili Deng, Department of Medical Oncology, The Second Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China, Email dengdoctor@126.comBackground: Surgical procedure is the preferred option for people with early-stage non-small cell lung cancer (NSCLC), while nearly 30% of patients experienced metastatic or recurrent tumor after operation. The primary intention of this context is to summarize high-risk prognostic factors and set up a novel nomogram to predict the overall survival of individuals with stage I NSCLC after resection.Methods: Research objects, 10,218 patients with stage I NSCLC after operation from 2010 to 2015, were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Independent prognostic factors, confirmed by Cox regression analyses, were integrated into a nomogram, to predict the 3-and 5-year overall survival of these individuals. The model experienced internal validation of testing cohorts above and external validation crewed by 160 patients from China. Finally, the nomogram was evaluated through several verification methods such as concordance index (C-index), calibration plots and receiver operating characteristic curve (ROC).Results: Multivariate analysis identified that age, gender, histologic type, differentiation class, type of operation, T stage and treatment were significant predictive factors for the survival of stage I NSCLC. Based on these factors, a nomogram was constructed to predict the 3- and 5-year overall survival of these individuals. Meanwhile, in the training set, this nomogram displayed excellent superiority over the TNM staging system with abroad application, especially in C-index (0.669 vs 0.580) and the AUC (the Area Under ROC Curve) for the 3- and 5-year survival (0.678 vs 0.582; 0.650 vs 0.576). In the calibration curve, the curve representing predicted survival tended to align with the line representing actual survival as well.Conclusion: A nomogram was successfully created and verified to achieve the goal that made a rounded accurate prediction on the survival of postoperative I NSCLC patients in terms of the SEER database.Keywords: NSCLC, nomogram, prognosis, SEER, survivalhttps://www.dovepress.com/establishment-and-validation-of-a-predictive-nomogram-for-postoperativ-peer-reviewed-fulltext-article-IJGMnsclcnomogramprognosisseersurvival
spellingShingle Wang ZH
Deng L
Establishment and Validation of a Predictive Nomogram for Postoperative Survival of Stage I Non-Small Cell Lung Cancer
International Journal of General Medicine
nsclc
nomogram
prognosis
seer
survival
title Establishment and Validation of a Predictive Nomogram for Postoperative Survival of Stage I Non-Small Cell Lung Cancer
title_full Establishment and Validation of a Predictive Nomogram for Postoperative Survival of Stage I Non-Small Cell Lung Cancer
title_fullStr Establishment and Validation of a Predictive Nomogram for Postoperative Survival of Stage I Non-Small Cell Lung Cancer
title_full_unstemmed Establishment and Validation of a Predictive Nomogram for Postoperative Survival of Stage I Non-Small Cell Lung Cancer
title_short Establishment and Validation of a Predictive Nomogram for Postoperative Survival of Stage I Non-Small Cell Lung Cancer
title_sort establishment and validation of a predictive nomogram for postoperative survival of stage i non small cell lung cancer
topic nsclc
nomogram
prognosis
seer
survival
url https://www.dovepress.com/establishment-and-validation-of-a-predictive-nomogram-for-postoperativ-peer-reviewed-fulltext-article-IJGM
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