scholarly journals A nomogram model to predict death rate among non-small cell lung cancer (NSCLC) patients with surgery in Surveillance, Epidemiology, and End Results (SEER) database

2020 ◽  
Author(s):  
Bo Jia ◽  
Qiwen Zheng ◽  
Jingjing Wang ◽  
Hongyan Sun ◽  
Jun Zhao ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Death Rate ◽  
Prognostic Model ◽  
Small Cell ◽  
Seer Database ◽  
Small Cell Lung ◽  
Nsclc Patients

Abstract Background This study aimed to establish a novel nomogram prognostic model to predict death probability for non-small cell lung cancer (NSCLC) patients who received surgery. Methods We collected data from the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute in the United States. A nomogram prognostic model was constructed to predict mortality of NSCLC patients who received surgery. Results A total of 44,880 NSCLC patients who received surgery from 2004 to 2014 were included in this study. Gender, race, tumor anatomic sites, histologic subtype, tumor differentiation, clinical stage, tumor size, tumor extent, lymph node stage, examined lymph node, positive lymph node, type of surgery showed significant associations with lung cancer related death rate (P<0.001). Patients who received chemotherapy and radiotherapy had significant higher lung cancer related death rate but were associated with significant lower non-cancer related mortality (P<0.001). A nomogram model was established based on multivariate models of training data set. In the validation cohort, the unadjusted C-index was 0.73 (95% CI, 0.72-0.74), 0.71 (95% CI, 0.66-0.75) and 0.69 (95% CI, 0.68-0.70) for lung cancer related death, other cancer related death and non-cancer related death. Conclusions A prognostic nomogram model was constructed to predict death rate for NSCLC patients who received surgery. This novel prognostic model may be helpful for physicians to develop the most appropriate treatment strategies for resected NSCLC patients. Parts of these results were presented at the 2018 American Society of Clinical Oncology Annual Meeting (Abstract #8525)

A nomogram for predicting overall survival in resected non-small cell lung cancer with chemotherapy.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e21064-e21064
Author(s):  
Yuan Zeng ◽  
Wenhua Liang ◽  
Jianxing He
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Seer Database ◽  
Small Cell Lung ◽  
Lymph Node Count ◽  
Resected Nsclc ◽  
Nsclc Patients

e21064 Background: Chemotherapy is very common for resected Non-Small-Cell Lung Cancer (NSCLC) patients. However, models for predicting the survival outcomes of resected NSCLC patients with chemotherapy are scarce. The aim of this study was to develop a clinical nomogram for predicting overall survival in these patients. Methods: A total of 16661 resected NSCLC with chemotherapy were cases extracted from the Surveillance, Epidemiology, and End Results (SEER) database. We identified and integrated the prognostic factors to build a nomogram.The model was subjected to bootstrap internal validation with the SEER database and external validations with 1108 patients from China. The predictive accuracy and discriminative ability were illustrated by calibration, concordance index (C-index) and risk group stratification. Results: On multivariate analysis independent factors for OS were age, sex, examined lymph node count, extent of surgery, N stage, T stage and grade which were then integrated into the nomogram. The calibration curves for probability of 1-, 3-, and 5-year OS showed excellent agreement between nomogram prediction and actual observation. The C-index of the nomogram was higher than that of AJCC 8th edition system for predicting OS (training cohort, 0.61 vs. 0.58; P < 0.01; validation cohort, 0.66 vs. 0.63, P = 0.56). The stratification into different risk groups allowed significant distinction between survival curves. Conclusions: We established a nomogram that can provide individual prediction of OS for resected NSCLC patients with chemotherapy. This practical prognostic model may help clinicians for treatment planning and to guide future studies.

Genetic variants in NPAS2 gene and clinical outcomes of resectable non-small-cell lung cancer

2021 ◽  
Vol 17 (7) ◽  
pp. 795-805
Author(s):  
Yiwei He ◽  
Gang Wang ◽  
Qian Wang ◽  
Zheng Zhao ◽  
Lu Gan ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Genetic Variants ◽  
Small Cell ◽  
Small Cell Lung ◽  
Node Metastasis ◽  
Nsclc Patients

Background: A series of studies have demonstrated that NPAS2 plays a critical role in the development and progression of several cancers. However, the association between genetic variants in the  NPAS2 gene and the clinical outcome of patients with non-small-cell lung cancer (NSCLC) has not been investigated. Methods: Six functional SNPs in NPAS2 were selected and genotyped using the Sequenom iPLEX genotyping system in a cohort of 484 Chinese NSCLC patients undergoing surgery. Multivariate Cox proportional hazards model were used for the prognosis analysis. Results: We found that SNP rs2305158 exhibited a significant association with overall survival of NSCLC patients in the dominant model (hazard ratio [HR]: 0.68; 95% CI: 0.49–0.95; p = 0.02). Lymph node metastasis was significantly associated with increased death risk (HR: 1.73; 95% CI: 1.24–2.40; p = 0.001) in patients with the homozygous wildtype (WW) genotype of rs2305158. However, no significant association was observed between them in patients carrying a heterozygous variant (WV) or homozygous variant (VV) genotype of rs2305158. Finally, in the joint and interaction analysis, the patients carrying homozygous wildtype (WW) genotype and lymph node metastasis from N1 to N3 conferred a significant increased effect on death (HR: 2.29; 95% CI: 1.40–3.76; p = 0.001). Conclusions: Our results suggest that NPAS2 polymorphisms may serve as an independent prognostic marker for NSCLC patients.

Real-world treatment patterns in stages IA-IIIB non-small cell lung cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e20528-e20528
Author(s):  
Jay M. Lee ◽  
Rongrong Wang ◽  
Ibrahim M. Abbass ◽  
Daniel Sheinson ◽  
Matthew Kent ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Real World ◽  
Systemic Therapy ◽  
Small Cell ◽  
Stage Ii ◽  
Small Cell Lung ◽  
Nsclc Patients

e20528 Background: Given the rising number of immunotherapy or targeted therapy trials, a call for real-world treatment (Tx) data among resectable non-small cell lung cancer (NSCLC) patients is needed. We describe Tx patterns and timelines to Tx. Methods: Retrospective data were collected from the SEER Medicare database. Patient inclusion criteria: newly diagnosed NSCLC stages IA to IIIB between 2010 and 2015, ≥65 years of age, and continuously enrolled in Medicare Part A and B and no HMO enrollment for ≥7 months prior to diagnosis (Dx) date. A subset of patients with a follow-up of ≥12 months after Dx or ≥6 months after surgery were evaluated for Tx patterns. Results: Among 31,921 NSCLC patients identified, the mean (SD) age was 76 (7) years and 51% were female. AJCC (7th edition) stages included IA (25%), IB (21%), II (8%), IIIA (17%), and IIIB (30%). Among the 6,559 (21%) patients identified with a solitary pulmonary nodule (SPN) prior to Dx, the median [IQR] time from SPN to Dx was 29 [13, 67] days. Among the 24,952 (78%) patients who received Tx, the median [IQR] time from Dx to Tx was 31 [14, 54] days. Among 19,304 patients included in the Tx pattern analysis, 63% did not undergo surgery. Among resected patients with lymph node metastasis, only 64% (stage II), 74% (stage IIIA), and 52% (stage IIIB) of patients received chemotherapy (CT) before or after surgery (Table). Median [IQR] time in days between Dx and neoadjuvant or adjuvant CT was 29 [14, 48] and 84 [56, 119], respectively. Median [IQR] time in days between Dx and surgery was longer for patients with neoadjuvant Tx (Table). Median [IQR] time between surgery to adjuvant CT was 46 [33, 63] days, with 59% of patients receiving their adjuvant CT ≥ 6 weeks after surgery and 33% of patients receiving their adjuvant CT ≥ 8 weeks after surgery. Conclusions: A significant proportion of lymph node positive stage II or III NSCLC patients did not receive perioperative systemic therapy despite standard of care guidelines. This finding suggests a patient population with unmet need notwithstanding recommendations for systemic therapy. [Table: see text]

scholarly journals A prognostic model for elderly patients with squamous non-small cell lung cancer: a population-based study

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Siying Chen ◽  
Chunxia Gao ◽  
Qian Du ◽  
Lina Tang ◽  
Haisheng You ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Elderly Patients ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Prognostic Model ◽  
Small Cell ◽  
The Novel ◽  
Seer Database ◽  
Small Cell Lung ◽  
Ajcc Stage

Abstract Background Squamous cell carcinoma (SCC) is a main pathological type of non-small cell lung cancer. It is common among elderly patients with poor prognosis. We aimed to establish an accurate nomogram to predict survival for elderly patients (≥ 60 years old) with SCC based on the Surveillance, Epidemiology, and End Results (SEER) database. Methods The gerontal patients diagnosed with SCC from 2010 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. The independent prognostic factors were identified using multivariate Cox proportional hazards regression analysis, which were utilized to conduct a nomogram for predicting survival. The novel nomogram was evaluated by Concordance index (C-index), calibration curves, net reclassification improvement (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA). Results 32,474 elderly SCC patients were included in the analysis, who were randomly assigned to training cohort (n = 22,732) and validation cohort (n = 9742). The following factors were contained in the final prognostic model: age, sex, race, marital status, tumor site, AJCC stage, surgery, radiation and chemotherapy. Compared to AJCC stage, the novel nomogram exhibited better performance: C-index (training group: 0.789 vs. 0.730, validation group: 0.791 vs. 0.733), the areas under the receiver operating characteristic curve of the training set (1-year AUC: 0.846 vs. 0.791, 3-year AUC: 0.860 vs. 0.801, 5-year AUC: 0.859 vs. 0.794) and the validation set (1-year AUC: 0.846 vs. 0.793, 3-year AUC: 0.863 vs. 0.806, 5-year AUC: 0.866 vs. 0.801), and the 1-, 3- and 5-year calibration plots. Additionally, the NRI and IDI and 1-, 3- and 5-year DCA curves all confirmed that the nomogram was a great prognosis tool. Conclusions We constructed a novel nomogram that could be practical and helpful for precise evaluation of elderly SCC patient prognosis, thus helping clinicians in determining the appropriate therapy strategies for individual SCC patients.

scholarly journals Lobectomy Can Improve the Survival of Patients With Non-small Cell Lung Cancer With Lung Oligometastatic

2021 ◽  
Vol 8 ◽  
Author(s):  
Lingwei Wang ◽  
Fanglei Jiao ◽  
Lin Dong ◽  
Qinchuan Li ◽  
Gang Liu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Seer Database ◽  
Small Cell Lung ◽  
Pulmonary Surgery ◽  
Organ Metastasis ◽  
Nsclc Patients ◽  
Single Organ

Background: This study was to evaluate the value of lobectomy in the prognosis of Non-small cell lung cancer (NSCLC) patients with primary metastasis based on the Surveillance Epidemiology and End Results (SEER) database.Methods: This was a population-based retrospective study and the clinical data were collected from the National Cancer Institute's SEER database between 2010 and 2015. The effects of pulmonary surgery and surgical procedures on lung cancer-specific survival (LCSS) and overall survival (OS) were assessed, and the COX regression models were employed to evaluate the survival of primary surgery in patients with primary metastatic NSCLC (pmNSCLC) and the survival of surgical procedure in pmNSCLC patients.Results: A total of 55,717 patients diagnosed with pmNSCLC between 2010 and 2015 were enrolled, and pulmonary surgery was indicated in 1,575 (2.83%) patients. Surgery was an independent risk factor for LCSS (P &lt; 0.001, HR 0.658, 95%CI: 0.637–0.680) and OS (P &lt; 0.001, HR 0.665, 95%CI: 0.644–0.686) of pmNSCLC patients. The surgery was associated with better OS (P &lt; 0.001, HR 0.678, 95%CI: 0.657–0.699). The site of metastasis was also related to the survival after primary tumor surgery (P = 0.001). As compared to the sublobectomy and pneumonectomy, lobectomy improved the LCSS for NSCLC patients with single-organ metastasis, rather than multiple metastases (P &lt; 0.001). In patients receiving sublobectomy, lobectomy, and pneumonectomy, the median LCSS was 12, 28, and 13 months, respectively, and the 5-year LCSS rate was 14.39, 32.06, and 17.24%, respectively.Conclusion: The effect of locoregional surgery on the survival of pmNSCLC patients with single-organ metastasis has been underestimated, and lobectomy may be a preferred treatment for patients with single-lung metastasis.

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