Validation of the Eighth Edition TNM Lung Cancer Staging System

Hwang, Joseph; Page, Barbara; Flynn, David; Passmore, Linda; McCaul, Elizabeth; Brady, Jaccalyne; Yang, Ian A.; Marshall, Henry; Windsor, Morgan; Bowman, Rayleen V.; Guan, Tracey; Philpot, Shoni; Blake, Michael E.; Fong, Kwun M.

doi:10.1016/j.jtho.2019.11.030

Cited by 42 publications

(29 citation statements)

References 11 publications

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“…We reviewed the SEER database ( Myers and Ries, 1989 ) for cases with definite 7th edition AJCC pathological stages between 2010 and 2015, and found that even in patients with T1 stage, 54.2% (4,907/9,049) had lymph node metastasis, while the proportion of lymph node metastasis did not increase significantly with the increase of T stage [T2: 49.9% (5,382/10,793), T3: 65.2% (6,245/9,582), T4: 73.1% (8,991/12,296)]. Clarification of lymph node metastasis status is crucial for the treatment of patients as well as for the assessment of their prognosis ( Hwang et al, 2020 ). The commonly used noninvasive clinical examinations are CT and PET/CT, but these two modalities are not accurate enough for the diagnosis of lymph node metastasis and there is a certain possibility of missing the diagnosis ( Li et al, 2013 ; El-Sherief et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Identification and Validation of Immune-Related Gene Signature for Predicting Lymph Node Metastasis and Prognosis in Lung Adenocarcinoma

Jia

Sui

Zhang

et al. 2021

Front. Mol. Biosci.

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Lung cancer is a serious malignancy, and lung adenocarcinoma (LUAD) is the most common pathological subtype. Immune-related factors play an important role in lymph node metastasis. In this study, we obtained gene expression profile data for LUAD and normal tissues from the TCGA database and analyzed their immune-related genes (IRGs), and observed that 459 IRGs were differentially expressed. Further analysis of the correlation between differentially expressed IRGs and lymph node metastasis revealed 18 lymph node metastasis-associated IRGs. In addition, we analyzed the mutations status, function and pathway enrichment of these IRGs, and regulatory networks established through TF genes. We then identified eight IRGs (IKBKB, LTBR, MIF, PPARD, PPIA, PSME3, S100A6, SEMA4B) as the best predictors by LASSO Logistic analysis and used these IRGs to construct a model to predict lymph node metastasis in patients with LUAD (AUC 0.75; 95% CI: 0.7064–0.7978), and survival analysis showed that the risk score independently affected patient survival. We validated the predictive effect of risk scores on lymph node metastasis and survival using the GEO database as a validation cohort and the results showed good agreement. In addition, the risk score was highly correlated with infiltration of immune cells (mast cells activated, macrophages M2, macrophages M0 and B cells naïve), immune and stromal scores, and immune checkpoint genes (LTBR, CD40LG, EDA2R, and TNFRSF19). We identified key IRGs associated with lymph node metastasis in LUAD and constructed a reliable risk score model, which may provide valuable biomarkers for LUAD patients and further reveal the mechanism of its occurrence.

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Section: Discussionmentioning

confidence: 99%

Identification and Validation of Immune-Related Gene Signature for Predicting Lymph Node Metastasis and Prognosis in Lung Adenocarcinoma

Jia

Sui

Zhang

et al. 2021

Front. Mol. Biosci.

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“…Our study suggested that low CHRDL1 in LUAD was significantly related to advanced clinicopathological features(high T and N stage, positive tumor status, poor treatment effect and TP53 mutation). TNM stage has been used to assess the severity of tumor extent, lymph node invasion and distant metastasis since 1966 [ 49 ]. In our study, CHRDL1 is only related to T and N stage, not to M stage.…”

Section: Discussionmentioning

confidence: 99%

Chordin-like 1 is a novel prognostic biomarker and correlative with immune cell infiltration in lung adenocarcinoma

Deng

Chen

et al. 2022

Aging

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Chordin-like 1 (CHRDL1), an inhibitor of bone morphogenetic proteins(BMPs), has been recently reported to participate in the progression of numerous tumors, however, its role in lung adenocarcinoma (LUAD) remains unclear. Our study aimed to demonstrate relationship between CHRDL1 and LUAD based on data from The Cancer Genome Atlas (TCGA). Among them, CHRDL1 expression revealed promising power for distinguishing LUAD tissues form normal sample. Low CHRDL1 was correlated with poor clinicopathologic features, including high T stage (OR=0.45, P <0.001), high N stage (OR=0.57, P <0.003), bad treatment effect (OR=0.64, P =0.047), positive tumor status (OR=0.63, P =0.018), and TP53 mutation (OR=0.49, P <0.001). The survival curve illustrated that low CHRDL1 was significantly correlative with a poor overall survival (HR=0.60, P <0.001). At multivariate Cox regression analysis, CHRDL1 remained independently correlative with overall survival. GSEA identified that the CHRDL1 expression was related to cell cycle and immunoregulation. Immune infiltration analysis suggested that CHRDL1 was significantly correlative with 7 kinds of immune cells. Immunohistochemical validation showed that CHRDL1 was abnormally elevated and negatively correlated with Th2 cells in LUAD tissues. In conclusion, CHRDL1 might become a novel prognostic biomarker and therapy target in LUAD. Moreover, CHRDL1 may improve the effectiveness of immunotherapy by regulating immune infiltration.

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“…19 To be eligible for inclusion, patients should meet the following criteria: (1) pathologically confirmed NSCLC; (2) primary site codes from C34.0 to C34.9; (3) been of adult age; (4) been diagnosed between 2010 and 2016. In contrast, patients with the following conditions were excluded from the study: (1) diagnosed by either autopsy or death certificate; (2) had the second primary tumor; (3) lacked their follow-up status; (4) lacked details of clinicopathological information; (5) without BM or BM status missing/unknown. The flowchart of patient selection is shown in Figure 1.…”

Section: Patients Selectionmentioning

confidence: 99%

“…NSCLC is the most common lung cancer type, accounting for approximately 85% lung cancer cases. 5 , 6 NSCLC can be classified into three major subtypes: adenocarcinoma (40% of NSCLC), squamous (25–30% of NSCLC), and other subtypes. 7 , 8 It is estimated that >50% of NSCLC patients have already developed into (at least) stage III disease, which needs multimodality therapies.…”

Section: Introductionmentioning

confidence: 99%

Construction and Validation of Two Novel Nomograms for Predicting the Overall Survival and Cancer-Specific Survival of NSCLC Patients with Bone Metastasis

Dong¹,

Deng²,

Mok³

et al. 2021

IJGM

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Background: Bone metastasis (BM) is the most common site of metastasis in non-small cell lung carcinoma (NSCLC). We aimed to construct and validate 2 novel nomograms predicting the 3-, 6-, and 12-months overall survival (OS) and cancer-specific survival (CSS). Methods: The clinical data of 7480 patients between 2010 and 2016 were enrolled from the Surveillance, Epidemiology, and End Results database (SEER). The patients were allocated randomly to training and validation cohorts in a 7:3 ratio. Cox proportional hazards regression models were used to identify prognostic risk factors and establish 2 nomograms. The prediction accuracy of nomograms was assessed by C-index, the area under the ROC curve (AUC), and calibration curves. Results: A total of 244998 NSCLC patients were identified between 2010 and 2016, with 7480 found with BM, accounting for 3.1%. Overall, 7480 patients were enrolled in the OS nomogram construction and were randomized to the training set (n = 5236) and the validation set (n = 2244). Age, sex, race, marital status, histology, grade, primary site, T stage, N stage, liver metastasis, surgery, radiotherapy, and chemotherapy were found to correlate with OS. A total of 7422 samples were included in the CSS nomogram construction, randomly grouped into training set (n = 5195) and the validation set (n = 2227). Age, sex, race, histology, grade, primary site, T stage, N stage, brain metastasis, liver metastasis, surgery, radiotherapy, and chemotherapy were associated with CSS. Two nomograms were conducted to predict the 3-, 6-, and 12-months OS and CSS. The ROC curves and exhibited good performance for predicting OS and CSS. Conclusion:We established and validated 2 high-performance nomograms to assist clinical doctors in making personalized treatment decisions.

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Validation of the Eighth Edition TNM Lung Cancer Staging System

Cited by 42 publications

References 11 publications

Identification and Validation of Immune-Related Gene Signature for Predicting Lymph Node Metastasis and Prognosis in Lung Adenocarcinoma

Identification and Validation of Immune-Related Gene Signature for Predicting Lymph Node Metastasis and Prognosis in Lung Adenocarcinoma

Chordin-like 1 is a novel prognostic biomarker and correlative with immune cell infiltration in lung adenocarcinoma

Construction and Validation of Two Novel Nomograms for Predicting the Overall Survival and Cancer-Specific Survival of NSCLC Patients with Bone Metastasis

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