Establishment and validation of a long-term prognosis prediction model for patients with non-small cell lung cancer

Abstract

Background: The incidence of non-small cell lung cancer ranks second among malignant tumors, while the mortality rate ranks first. We established a prediction model for the long-term prognosis of lung cancer patients to accurately identify patients with a high risk of postoperative death and provide a theoretical basis for improving the prognosis of patients with non-small cell lung cancer. Methods:The data of 277 non-small cell lung cancer patients who underwent radical lung cancer resection at Shanghai Fengxian District Central Hospital between January 2016 and December 2017 were retrospectively collected. The patients, who were followed up for 5 years, were divided into a deceased group (n=127) and survival group (n=150) according to whether the patients had died 5 years after surgery or not. The clinical characteristics of the two groups were observed, and the risk factors of death within 5 years of surgery in lung cancer patients were analyzed. A nomogram predictive model was then established to analyze the value of the model in predicting the death within 5 years of surgery in patients with non-small cell lung cancer.Results: Multivariate logistics regression analysis showed that carcinoembryonic antigen (CEA) >193.5 ng/mL, stage III lung cancer, peritumor invasion, and vascular tumor thrombus were independent risk factors of tumor-specific death after surgery in patients with non-small cell lung cancer (P<0.05). R 4.0.3 statistical software was used to randomly divide the dataset into a training set and validation set. The sample size of the training set was 194, and the sample size of the validation set was 83. The area under the receiver operating characteristic (ROC) curve was 0.850 [95% confidence interval (CI): 0.796-0.905] in the training set, and it was 0.779 (95% CI: 0.678-0.880) in the validation set. In the validation set, the model was assessed using the Hosmer-Lemeshow goodness-of-fit test, with a chi-square value of 9.270 and a P value of 0.320.Conclusions: Our model could accurately identify high risk of death within 5 years of surgery in nonsmall cell lung cancer patients. Strengthening the management of high-risk patients may help improve the prognosis of these patients.

Clinical characteristics and novel strategies of immune checkpoint inhibitor rechallenge therapy for non-small cell lung cancer: a comprehensive review

“…There have been some advances in surgery, radiotherapy, chemotherapy, and targeted therapy in treating this condition, and targeted therapy significantly improves the prognosis of patients with gene mutations; for example, compared with chemotherapy, postoperative adjuvant targeted therapy significantly improves the survival time and five-year disease-free survival rate of stage IIIA EGFR-positive NSCLC patients, with a 13.0% increase in five-year survival rate (2). However, despite these improvements, the 5-year survival rate of patients with advanced NSCLC remains not high (3). Targeted therapy can consider immunotherapy after drug resistance.…”