Prognostic Factors and Prediction of Survival for Patients with Brain Metastases of Lung Adenocarcinoma

Zheng, Rongjiong; Guo, Dina; Dong, Yongquan; Wang, Mingming; Hu, Meiling; Ren, Yifeng

doi:10.1272/jnms.jnms.2021_88-410

Cited by 3 publications

(3 citation statements)

References 21 publications

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“…The area under the curve (AUC) for the 3- and 5-year OS demonstrated excellent prognostic accuracy in both the training and validation cohorts ( 8 ). The SEER database contained a wealth of information on patients with LUAD and was widely used for prognostic modeling of LUAD at different stages or in different populations ( 9 - 11 ). However, to date, no study has been conducted on the construction of prediction model for OS in stage III-N2 LUAD patients.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a nomogram for predicting overall survival in patients with stage III-N2 lung adenocarcinoma based on the SEER database

Zhang,

Xiao,

Qin

et al. 2023

Transl Cancer Res

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Background There is variability in the prognosis of stage III-N2 lung adenocarcinoma (LUAD) patients. The current tumor-node-metastasis (TNM) staging is not sufficient to precisely estimate the prognosis of stage III-N2 LUAD patients. The Surveillance, Epidemiology, and End Results (SEER) database collected first-hand information from a large number of LUAD patients. Based on the SEER database, this study aimed to determine the prognostic factors that affect overall survival (OS) in stage III-N2 LUAD patients and then establish a nomogram for predicting OS in this type of cancer to identify the high-risk population that may require more frequent surveillance or intensive care. Methods Data for 1,844 stage III-N2 primary LUAD patients who were registered between 2010 and 2015 were obtained from the SEER database. These patients were randomly assigned to either training (n=1,290) or validation (n=554) cohorts at a 7:3 ratio. The univariate and multivariate Cox regression (UCR and MCR) analyses were performed to find the relevant independent prognostic factors. To predict the OS based on these prognostic factors, a nomogram was then developed. The performance of the nomogram was examined based on the calibration curves, and receiver operating characteristic (ROC) curves. The ability of nomogram to stratify patient risk was validated by Kaplan-Meier survival analysis. Results Age, gender, tumor location, T-stage and treatment modality (chemotherapy, radiation therapy, surgery and scope of lymph node dissection) of stage III-N2 LUAD patients were significantly associated with prognosis. The area under the curve (AUC) values of OS predicted by the nomogram constructed with these factors at 12-, 36- and 60-month were 0.784, 0.762 and 0.763 in the training cohort, whereas 0.707, 0.685 and 0.705 in the validation cohort, respectively. Additionally, calibration curves demonstrated concordance between predicted and observed outcomes. Nomogram risk stratification provides a meaningful distinction between patients with various survival risks. Conclusions A survival prediction model that may be useful for risk stratification and decision-making is developed and validated for stage III-N2 LUAD patients. A high-risk patient predicted by the prediction model may require more frequent surveillance or intensive care.

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Section: Introductionmentioning

confidence: 99%

Development and validation of a nomogram for predicting overall survival in patients with stage III-N2 lung adenocarcinoma based on the SEER database

Zhang,

Xiao,

Qin

et al. 2023

Transl Cancer Res

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“…4 NSCLC is the main cause of cancer death worldwide, and more than 20% of patients have brain metastasis during treatment. 5 Brain involvement is an independent adverse prognostic factor with a median natural survival time of 1-2 months. The median survival time is only 4-12 months even with effective treatment.…”

Section: Introductionmentioning

confidence: 99%

“…The brain metastasis rate of patients with non‐small‐cell lung cancer (NSCLC) is as high as 44% 4 . NSCLC is the main cause of cancer death worldwide, and more than 20% of patients have brain metastasis during treatment 5 . Brain involvement is an independent adverse prognostic factor with a median natural survival time of 1–2 months.…”

Section: Introductionmentioning

confidence: 99%

Response and safety of whole‐brain radiotherapy plus temozolomide for patients with brain metastases of non‐small‐cell lung cancer: A meta‐analysis

Han

Qiu

et al. 2021

Thoracic Cancer

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The aim of the present work was to investigate the response and safety of whole-brain radiotherapy (WBRT) plus temozolomide (TMZ) for patients with brain metastases of non-small-cell lung cancer (NSCLC). Methods: The electronic databases of Pubmed, EMbase, Cochrane, Wangfang, china national knowledge infrastructure (CNKI), and Google scholar were systematically searched to identify the prospective randomized trials relevant to WBRT plus TMZ for patients with brain metastases of NSCLC. The data associated with treatment response and toxicity were extracted from original included studies. The relative risk (RR) for treatment response and toxicity between WBRT+TMZ and WBRT alone was pooled by fixed or random effect model. Publication bias was investigated by Begg's funnel plot and Egger's line regression test. Results: Twenty-five clinical trials fulfilled the inclusion criteria and were included in the meta-analysis. The pooled results showed WBRT+TMZ can significant improve the objective response rate (ORR) compared with WBRT alone (RR = 1.43, 95% confidence interval [CI] 1.32-1.55, p < 0.05) under a fixed effect model. WBRT+TMZ significantly increased the III-IV hematological toxicity compared to WBRT alone (RR = 1.66, 95% CI 1.12-2.54, p < 0.05) in the fixed effect model. Grade III-IV gastrointestinal toxicity was increased in WBRT+TMZ compared to WBRT alone (RR = 1.72, 95% CI 1.29-2.30, p < 0.05). Begg's funnel plot and Egger's line regression test indicated publication bias. Conclusion: Based on the present work, WBRT+TMZ can improve the ORR for brain metastases of NSCLC, but the risk of treatment-associated grade III/IV hematological toxicity and gastrointestinal toxicity were also increased compared to WBRT alone.

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The Prognostic Nutritional Index as a Predictor of Gastric Cancer Progression and Recurrence

2022

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Background: Gastric cancer can recur soon after treatment. We evaluated the prognostic nutritional index (PNI), a predictor of postoperative complications, and examined the association of PNI with progression and recurrence of gastric cancer. Methods:We retrospectively investigated data from 697 patients who had undergone surgery for gastric carcinoma (excluding those with stage IV disease) and analyzed associations of age, sex, performance status (PS), American Society of Anesthesiologists (ASA) classification, diabetes, depth of main tumor (T), lymph node metastasis, postoperative complications, recurrence, and survival with PNI. We also performed multivariate analysis to identify factors associated with survival.Results: PNI significantly decreased with age and was significantly lower in women. PNI was significantly positively correlated with PS. PNI was significantly lower for ≥T2 cancers and in patients with lymph node metastasis. There was no association between postoperative complications and PNI. PNI was significantly lower for patients who developed recurrence than for those who did not. The survival rate was examined for groups with a PNI of ≥45 (high PNI) and <45 (low PNI). Both 5-year overall survival (OS) and cancer-specific survival (CS) were significantly worse for the low PNI group. Multivariate analysis showed that PNI was an independent predictor of OS and CS.Conclusions: PNI was associated with progression and recurrence of gastric cancer.

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Prognostic Factors and Prediction of Survival for Patients with Brain Metastases of Lung Adenocarcinoma

Cited by 3 publications

References 21 publications

Development and validation of a nomogram for predicting overall survival in patients with stage III-N2 lung adenocarcinoma based on the SEER database

Development and validation of a nomogram for predicting overall survival in patients with stage III-N2 lung adenocarcinoma based on the SEER database

Response and safety of whole‐brain radiotherapy plus temozolomide for patients with brain metastases of non‐small‐cell lung cancer: A meta‐analysis

The Prognostic Nutritional Index as a Predictor of Gastric Cancer Progression and Recurrence

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