International Journal of General Medicine (Apr 2022)

Development and Validation of a Nomogram for Predicting Overall Survival in Patients with Second Primary Small Cell Lung Cancer After Non-Small Cell Lung Cancer: A SEER-Based Study

  • Zhu J,
  • Shi H,
  • Ran H,
  • Lai Q,
  • Shao Y,
  • Wu Q

Journal volume & issue
Vol. Volume 15
pp. 3613 – 3624

Abstract

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Ju Zhu,1 Haoming Shi,1 Haoyu Ran,1 Qiancheng Lai,2 Yue Shao,1 Qingchen Wu1 1Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Cardiothoracic Surgery, Chengdu Fifth People’ Hospital, Chengdu, People’s Republic of ChinaCorrespondence: Qingchen Wu, Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China, Email [email protected]: Non-small cell lung cancer (NSCLC) survivors are at an increased risk of developing second primary malignancies, such as small cell lung cancer. This paper sought to establish a prognostic nomogram to assess overall survival (OS) in patients with second primary small cell lung cancer (SPSCLC) after NSCLC.Methods: 420 patients who developed SPSCLC after NSCLC were randomly split into the training and validation groups. A nomogram was established by stepwise regression. Area under the curve (AUC) and calibration plots were applied to assess the prognostic performance of the nomogram. Concordance index (C-index), integrated discrimination improvement (IDI), net reclassification index (NRI) and decision curve analysis (DCA) were performed to compare the nomogram with the American Joint Committee on Cancer (AJCC) 8th staging system. Survival risk classification was constructed based on the nomogram.Results: Five variables were chosen to construct the nomogram. The AUC showed that it had a satisfactory discrimination ability. All calibration plots displayed good concordance between nomogram and observation. The C-index, IDI, NRI and DCA showed the nomogram was superior to the AJCC 8th staging system. The Kaplan-Meier curves suggested huge differences in prognosis among the three risk groups.Conclusion: This study build a nomogram and risk stratification system for predicting probabilities of OS in patients with SPSCLC after NSCLC, which can help clinicians in individualized survival assessment and treatment decisions.Keywords: nomogram, non-small cell lung cancer (NSCLC), small cell lung cancer (SCLC), SEER database

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