Cancer Management and Research (Dec 2019)
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
Abstract
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 ChinaCorrespondence: Jialun ShiDepartment 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 ChinaTel +86-13122625627Email [email protected]: 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
