A nomogram to predict prognosis after surgery in early stage non-small cell lung cancer in elderly patients

Int J Surg. 2017 Jun:42:11-16. doi: 10.1016/j.ijsu.2017.04.024. Epub 2017 Apr 17.

Abstract

Background: The aim of this study was to identify risk factors affecting overall survival (OS) of elderly patients with early stage NSCLC, and develop a nomogram for prognostic prediction of these patients using data from the Surveillance, Epidemiology, and End Results (SEER) database.

Methods: Data from the SEER database of patients aged ≥ 65 years with early (T1N0M0) NSCLC diagnosed between 2004 and 2013 were examined. The prognostic effect of each variable on survival was evaluated using the Kaplan-Meier method and the Cox proportional hazards regression model. A nomogram was formulated to predict the 3- and 5-year OS rates of elderly patients with early stage NSCLC.

Results: Finally, a total of 20,782 patients were included in this research. Cox regression analysis showed that sex, age, pathological type, diameter, differentiation, and surgery type were independent risk factors. A nomogram was formulated based on the results of multivariate analysis (all p < 0.001) and validated using an internal bootstrap resampling approach, which showed that the nomogram exhibited a sufficient level of discrimination according to the C-index (0.638, 95% CI = 0.629-0.647).

Conclusions: The nomogram developed in this study demonstrated its discrimination capability to predict the 3- and 5-year OS rates of elderly patients with early stage NSCLC based on individual characteristics.

Keywords: Early; Elderly; NSCLC; Nomogram; Risk factors.

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Male
  • Multivariate Analysis
  • Neoplasm Grading
  • Neoplasm Staging
  • Nomograms*
  • Pneumonectomy / methods*
  • Prognosis
  • Proportional Hazards Models
  • Risk Factors
  • SEER Program
  • Sex Factors
  • Survival Rate
  • Tumor Burden