Mining prognostic factors of extensive-stage small-cell lung cancer patients using nomogram model

Abstract

This study is to establish the nomogram model and provide clinical therapy decision-making for extensive-stage small-cell lung cancer (ES-SCLC) patients with different metastatic sites using the Surveillance, Epidemiology, and End Results (SEER) Program. A total of 10,025 patients of ES-SCLC with metastasis from January 2010 to December 2016 were enrolled from the SEER database. All samples were randomly divided into a derivation cohort and a validation cohort, and the derivation cohort was divided into 6 groups by different metastatic sites: bone, liver, lung, brain, multiple organs, and other organs. Using Cox proportional hazards models to analyze candidate prognostic factors, screening out the independent prognostic factors to establish the nomogram. Compare the different models by Net reclassification improvement and integrated discrimination improvement. Concordance index (C-index) and the calibration curve were used to verify the prediction efficiency of the nomogram in the derivation cohort and validation cohort. In the derivation cohort, the median overall survival was 7 months. The overall survival rates at 6-month, 1-year, and 2-year were 55.07%, 24.61%, and 7.56%, respectively. The median survival time was 10, 8, 7, 9, 7, and 6 months for the 6 groups of different metastatic sites: other, bone, liver, lung, brain, and multiple organs, respectively. Age, sex, race, T, N, distant metastatic site, and chemotherapy were contained in the final nomogram prognostic model. The C-index was 0.6569777 in the derivation cohort and 0.8386301 in the validation cohort. The survival time of ES-SCLC patients with different metastatic sites was significantly different. The nomogram can effectively predict the prognosis of individuals and provide a basis for clinical decision-making.

A prognostic nomogram to predict survival in elderly patients with small-cell lung cancer: a large population-based cohort study and external validation

“…These were some unique disease features for elderly SCLC patients. In addition, we identified ten independent prognostic factors for OS and CSS, which were consistent with the previous findings [ 7 , 13 – 16 , 23 – 25 ]. Our model indicated that chemotherapy made the greatest contribution to the prognostic score.…”

“…Our model indicated that chemotherapy made the greatest contribution to the prognostic score. Multiple studies have proved that chemotherapy, as the most important treatment for SCLC, can prolong the survival time of patients [ 7 , 13 , 15 , 23 , 26 ]. Our analysis also indicated that AJCC stage and surgery had greater impacts on patient survival.…”

The prognostic risk stratification model for metastatic small-cell lung cancer: An analysis of the SEER database

“…Two retrospective studies of DM-SCLC based on the SEER database have been published. The study from Hongxiang Gao [ 14 ] reported 10025 patients with DM-SCLC from January 2010 to December 2016 who were included in the SEER database. The variables included in the predictive model in that study were age, sex, race, T stage, N stage, distant metastatic site, and chemotherapy.…”

A nomogram to predict the overall survival of patients with symptomatic extensive-stage small cell lung cancer treated with thoracic radiotherapy

“…At present, standard treatment for patients with ES-SCLC consists of 4-6 cycles of platinumbased chemotherapy with immunotherapy. However, approximately 20% of those diagnosed with SCLC are not offered chemotherapy (14). The chance of being offered treatment decreased with PS.…”