Journal of Shandong University (Health Sciences) ›› 2023, Vol. 61 ›› Issue (10): 23-37.doi: 10.6040/j.issn.1671-7554.0.2022.0743

• Clinical Medicine • Previous Articles     Next Articles

Constructing and validating a prognostic model for patients with stage IIIB non-small cell lung cancer based on SEER database

ZHAO Qidi1*, WANG Kai1*, ZHAO Xiaogang2, YAN Tao1, WANG Yadong1, DU Jiajun1,3   

  1. 1. Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong, China;
    2. Department of Thoracic Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, Shandong, China;
    3. Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong, China
  • Published:2023-11-08

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Abstract: Objective To investigate the prognosis of patients with stage IIIB non-small cell lung cancer(NSCLC)and to construct a prognostic tool that can be widely used in clinical practice. Methods Clinical data of patients with stage IIIB NSCLC were retrospectively collected from the Surveillance, Epidemiology and End Result(SEER)databases, and randomly grouped into the training set and validation set with a 7∶3 ratio. Information of patients with stage IIIB NSCLC treated in the Department of Thoracic Surgery of Shandong Provincial Hospital Affiliated to Shandong University during 2005 and 2019 was collected as a secondary validation set(SPH validation set). Univariate and multivariate Cox proportional hazards regression analyses were conducted in the training set to construct a nomogram and web tool. Receiver operating characteristic(ROC)curve, concordance index(C-index), and decision curve analyses were performed using R software to evaluate the nomogram and assess the clinical benefits. Results A total of 7,903 patients were involved, including 5,532 in the training set and 2,371 in the validation set. Altogether 10 variables were included in the nomogram, including gender, age, primary site of tumor, grade of tumor, histology of tumor, tumor-node-metastasis stage specific subgroups of ⅢB stage in the eighth edition, dissection of regional lymph node, extent of surgery, radiotherapy and chemotherapy. The area under the ROC curve(AUC)of 5-year overall survival(OS)was 0.724 and 0.708 in the training and validation sets, respectively. The C-index was 0.661, 0.649 and 0.685 in the training, validation and SPH validation sets, respectively. The calibration plot showed that the model had good predictive power. Surgery with chemotherapy was identified as the optimal treatment strategy compared to chemotherapy or radiotherapy alone(P<0.001). An interactive web tool was also constructed. Conclusion A prognostic nomogram was successfully constructed and an interactive web tool to predict patients’ survival was built.

Key words: Nomogram, Lung squamous cell carcinoma, Lung adenocarcinoma, Prognosis, Therapy, Web tool

CLC Number: 

  • R574
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