Prediction of Overall Survival of Patients with Completely Resected Non-Small Cell Lung Cancer: Analyses of Preoperative Spirometry, Preoperative Blood Tests, and Other Clinicopathological Data
Received 24 September 2019
Accepted for publication 3 December 2019
Published 13 December 2019 Volume 2019:11 Pages 10487—10497
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Beicheng Sun
Mengkun Shi,1 Cheng Zhan,2 Jialun Shi,3 Qun Wang2
1Department of Oncology, The Affiliated Heping Hospital of Changzhi Medical College, Changzhi City, Shanxi Province, People’s Republic of China; 2Department of Thoracic Surgery, ZhongShan Hospital, Fudan University, Shanghai, People’s Republic of China; 3Department of Thoracic Surgery, The Affiliated Heping Hospital of Changzhi Medical College, Changzhi City, Shanxi Province, People’s Republic of China
Correspondence: Jialun Shi
Department of Thoracic Surgery, The Affiliated Heping Hospital of Changzhi Medical College, 110 Yan’an South Road, Changzhi City, Shanxi Province 046000, People’s Republic of China
Purpose: Risk stratification of patients with non-small cell lung cancer (NSCLC) is crucial to select the appropriate treatments, but available models for patients with complete resection are unsatisfactory. The purpose of this study was to determine a prediction model based on clinical information, routine physical and blood tests, and molecular markers.
Patients and Methods: This was a retrospective cohort study of patients who underwent surgical resection for lung cancer between 2009 to 2013. Potential prognostic factors were used to build a full prediction model based on a multivariable Cox regression analysis. A nomogram was constructed. The risk stratification cutoffs for clinical use were determined based on the model.
Results: A total of 368 NSCLC patients with R0 resection were included. The final multivariable model indicated that low diffusing capacity of the lung for carbon monoxide (HR=1.66, 95% CI: 1.18–2.34), high platelet-to-lymphocyte ratio (HR=1.42, 95% CI: 1.04–1.95), histology type of squamous cell carcinoma and others (squamous cell carcinoma vs adenocarcinoma, HR=1.40, 95% CI: 1.01–1.96; others vs adenocarcinoma, HR=2.36, 95% CI: 1.15–4.84; P trend=0.001), N>0 status (HR=1.96, 95% CI: 1.42–2.70), high serum carcinoembryonic antigen levels (HR=1.61, 95% CI: 1.13–2.27), and postoperative chemotherapy (HR=0.53, 95% CI: 0.33–0.87) were independently associated with poor OS. The patients were classified into four risk groups according to the nomogram, and the OS was different among the four groups (P<0.05).
Conclusion: A nomogram was successfully constructed based on a multivariable analysis, and the nomogram can discriminate the OS of patients with NSCLC based on risk categories, but external validation is still necessary.
Keywords: non-small cell lung cancer, survival, prognosis, spirometry, biochemistry
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