Zhidong Wang, Cheng Gong, Youpu Zhang, Yongxiang Qian, Yang Liu, Ce Chao
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引用次数: 0
Abstract
Background: Although a strong survival benefit has been observed among small cell lung cancer (SCLC) patients undergoing surgery, not all SCLC patients benefit from surgery. To help clinicians make choices and decisions regarding surgical intervention, we have developed an effective model to screen beneficial candidates based on population and tumor characteristics.
Methods: Patients with SCLC were acquired from the Surveillance, Epidemiology, and End Results database. Propensity score matching (PSM) was performed to balance covariates between the surgery and non-surgery groups. We assumed that patients undergoing surgery between 2014 and 2018 would benefit from the procedure if their median cancer-specific survival (CSS) time was longer than that of non-surgical patients. Univariate and multivariable logistic analyses were used to identify independent factors of surgical benefit in the surgery group. According to these preoperative factors, a nomogram was built and then internal and external validation were performed.
Results: In total, 35,214 patients with complete data were included for subsequent analysis, 1,364 of whom underwent surgery. Before and after PSM, surgery was an independent factor of long-term survival, with a median CSS time of 37.00 months for the surgery group compared to 16.00 months for the non-surgery group. A multivariable logistic model identified T stage, N stage, M stage, tumor site, and age as independent factors, which were used to establish a stable predictive model.
Conclusions: We have built a preoperative predictive model for SCLC patients to screen for optimal surgery candidates. This model has the potential to help clinicians determine whether it is beneficial to operate on patients with SCLC.
期刊介绍:
Translational Cancer Research (Transl Cancer Res TCR; Print ISSN: 2218-676X; Online ISSN 2219-6803; http://tcr.amegroups.com/) is an Open Access, peer-reviewed journal, indexed in Science Citation Index Expanded (SCIE). TCR publishes laboratory studies of novel therapeutic interventions as well as clinical trials which evaluate new treatment paradigms for cancer; results of novel research investigations which bridge the laboratory and clinical settings including risk assessment, cellular and molecular characterization, prevention, detection, diagnosis and treatment of human cancers with the overall goal of improving the clinical care of cancer patients. The focus of TCR is original, peer-reviewed, science-based research that successfully advances clinical medicine toward the goal of improving patients'' quality of life. The editors and an international advisory group of scientists and clinician-scientists as well as other experts will hold TCR articles to the high-quality standards. We accept Original Articles as well as Review Articles, Editorials and Brief Articles.