Development and Validation of a Nomogram to Predict the Overall Survival of Patients with Stage I Non-Small Cell Lung Cancer After Surgery

Abstract

Background: This study aimed to establish an effective prognostic nomogram for stage I non-small cell lung cancer (NSCLC) patients receiving surgery.Methods: Stage I NSCLC patients at Taizhou Hospital of Zhejiang Province from October 2010 to June 2014 were included. Clinical, pathological and laboratory variables ascertained before surgery were selected through least absolute shrinkage and selection operator and Cox regression analysis, and a nomogram model was established. The nomogram model was validated using stage I NSCLC patients from the same institution between July 2014 and December 2015. Results: Training cohort included 274 patients. From 46 potential predictors, the independent risk factors for Overall survival (OS) of patients with stage I NSCLC were age, CA125, and tumor diameter. The C index of the nomogram model was 0.759(95% confidence interval (CI)，0.666–0.852). The area under the ROC curve of the nomogram was 0.776. The patients in the low-risk subgroup had significantly better survival than those in the high-risk subgroup (logrank, p < 0.001). The AUC in the validation cohort was 0.809, and the C index was 0.707(95% CI, 0.572-0.842).Conclusion: We developed a nomogram model that includes clinical, pathological and laboratory variables to predict the OS of stage I NSCLC patients.