Development and Validation of a Prognostic Nomogram in Lung Cancer With Obstructive Sleep Apnea Syndrome

Abstract

To analyze the prognostic factors and survival rate of lung cancer patients with obstructive sleep apnea (OSA) by nomogram. The nomogram was established by a development cohort (n = 90), and the validation cohort included 38 patients. Factors in the nomogram were identified by Cox hazard analysis. We tested the accuracy of the nomograms by discrimination and calibration, and plotted decision curves to assess the benefits of nomogram-assisted decisions. There were significant difference in sex, apnea hypopnea index (AHI), Tumor Node Metastasis (TNM), coronary heart disease, lowest arterial oxygen saturation [LSpO2 (%)], oxygen below 90% of the time [T90% (min)], the percentage of the total recorded time spend below 90% oxygen saturation (TS90%) and oxygen desaturation index (ODI4) between lung cancer subgroup and lung cancer with OSA subgroup (P < 0.05). Lung cancer patients with OSA age, AHI, TNM, cancer types, BMI and ODI4 were independent prognostic factor. Based on these six factors, a nomogram model was established. The c-index of internal verification was 0.802 (95% CI 0.767–0.885). The ROC curve analysis for the nomogram show 1-year survival (AUC = 0.827), 3-year survival (AUC = 0.867), 5-year survival (AUC = 0.801) in the development cohort were good accuracy. The calibration curve shows that this prediction model is in good agreement. Decision curve analysis (DCA) suggests that the net benefit of decision-making with this nomogram is higher, especially in the probability interval of <20% threshold. The nomogram can predict the prognosis of patients and guide individualized treatment.

A review of obstructive sleep apnea and lung cancer: epidemiology, pathogenesis, and therapeutic options

“…Liu et al. retrospectively analyzed the data of 410 patients with newly diagnosed lung cancer, and a total of 128 patients (31.2%) had OSA, a slightly lower prevalence compared to that reported by other studies ( 21 ).…”

“…Another clinical cohort study from Asia confirmed that the prevalence of OSA in patients with lung cancer was 57%, with moderate-severe OSA accounting for 27% of the total, especially in patients with SCLC, an elevated AHI, and oxygen desaturation index (ODI), indicating that hypoxia may be more severe (20). Liu et al retrospectively analyzed the data of 410 patients with newly diagnosed lung cancer, and a total of 128 patients (31.2%) had OSA, a slightly lower prevalence compared to that reported by other studies (21).…”

Association between mean platelet volume and obstructive sleep apnea-hypopnea syndrome: A systemic review and meta-analysis

“…Additionally, elevated MPV values can aid in identifying high-risk individuals with OSAHS and alert clinicians to the potential increased risk of CVDs. OSAHS is a chronic condition that can lead to various comorbidities, including respiratory diseases, endocrine dysfunction, and cognitive impairment [61][62][63]. CVDs are a prominent comorbidity of OSAHS, especially coronary artery disease [64].…”

LncR-GAS5 decrease in adenine phosphoribosyltransferase expresssion via binding TAF1 to increase kidney damage created by CIH

“…Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a sleep-related breathing disorder characterized by snoring and the repetitive collapse of the upper airways, which disrupts normal ventilation [ 1 , 2 ]. OSAHS is associated with multiple comorbidities, including cardiovascular events and chronic kidney disease (CKD).…”