Prognostic nomograms for predicting overall survival of stage I lung cancer patients: a large population-based study

Background Postoperative prognosis of stage I non-small cell lung cancer (NSCLC) undergoing lymph node dissection is heterogeneous. Therefore, we sought to construct a novel survival prediction model for stage I NSCLC undergoing lymph node dissection. Method: Based on the data from the Surveillance, Epidemiology, and End Results (SEER) program, we successfully determined and incorporated independent prognostic markers to construct the nomogram. The constructed nomogram was further subjected to external validation with an independent cohort of patients. The performance of the survival prediction model was assessed by concordance index, calibration plots, and risk subgroup classification. Results A total of 23394 patients from SEER registries (training cohort), as well as 7016 patients (verification cohort) was included. Age, gender, race, histology, differentiation grade, stage, and lymph node dissection mode were identified as significant prognostic parameters. A novel nomogram was developed and externally validated. The model displayed good discrimination with a C-index of 0.666 (95% CI, 0.652 to 0.681) and good calibration. Calibration plots demonstrated an optimal consistency between the nomogram predicted and actual observed probability of survival. Conclusion This novel nomogram incorporating the age, gender, race, histology, differentiation grade, stage, and lymph node dissection mode could be conveniently used to facilitate the individual prognosis prediction in stage I NSCLC patients.