Prognostic indicators and nomograms for postoperative survival among younger patients with non-small cell lung cancer.

IF 2.1 3区 医学 Q3 RESPIRATORY SYSTEM
Journal of thoracic disease Pub Date : 2025-04-30 Epub Date: 2025-04-28 DOI:10.21037/jtd-2025-348
Yi Liu, Qirui Chen, Zhirong Zhang, Huandong Huo, Takuya Watanabe, Shuo Chen, Bin Hu
{"title":"Prognostic indicators and nomograms for postoperative survival among younger patients with non-small cell lung cancer.","authors":"Yi Liu, Qirui Chen, Zhirong Zhang, Huandong Huo, Takuya Watanabe, Shuo Chen, Bin Hu","doi":"10.21037/jtd-2025-348","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Non-small cell lung cancer (NSCLC) diagnosed in younger patients represents a rare and distinct entity within lung cancer, yet prognostic indicators for younger patients surgically treated for NSCLC remain unclear. We aimed to analyze the long-term surgical outcomes in a large cohort and to identify predictors and to develop nomograms for effective survival prediction.</p><p><strong>Methods: </strong>The Surveillance, Epidemiology, and End Results (SEER) database [2010-2020] was queried for pathologically confirmed NSCLC cases who underwent cancer-directed surgery. We selected a cutoff age of 49 years or younger to define the younger cohort. The Kaplan-Meier method was used for survival analysis. Cox proportional hazards regression models were used to determine prognostic parameters associated with survival. Nomogram performance was assessed via receiver operating characteristic (ROC) curves and calibration curves in both the training and validation cohort.</p><p><strong>Results: </strong>Among the 2,584 younger patients surgically treated for NSCLC meeting the inclusion criteria, the 5-year overall survival (OS) and lung cancer-specific survival (LCSS) rates were 84.3% and 87.0%, respectively. Multivariate analysis identified age, gender, histology, T stage, tumor, node, metastasis (TNM) stage, and postoperative therapy as independent prognosticators. Nomograms exhibited robust predictive performance. The ROC areas for 5-year OS were 0.816 for the training cohort and 0.811 for the validation cohort, while for the 5-year LCSS, the areas were 0.845 and 0.848, respectively. Additionally, the calibration curves demonstrated a high degree of concordance between the actual and predicted values.</p><p><strong>Conclusions: </strong>We identified the independent survival factors among younger patients treated surgically for NSCLC and established nomograms for the prediction of the long-term survival, offering valuable insights into clinical decision-making for post-surgical treatment.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2365-2376"},"PeriodicalIF":2.1000,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090160/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of thoracic disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/jtd-2025-348","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/28 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Non-small cell lung cancer (NSCLC) diagnosed in younger patients represents a rare and distinct entity within lung cancer, yet prognostic indicators for younger patients surgically treated for NSCLC remain unclear. We aimed to analyze the long-term surgical outcomes in a large cohort and to identify predictors and to develop nomograms for effective survival prediction.

Methods: The Surveillance, Epidemiology, and End Results (SEER) database [2010-2020] was queried for pathologically confirmed NSCLC cases who underwent cancer-directed surgery. We selected a cutoff age of 49 years or younger to define the younger cohort. The Kaplan-Meier method was used for survival analysis. Cox proportional hazards regression models were used to determine prognostic parameters associated with survival. Nomogram performance was assessed via receiver operating characteristic (ROC) curves and calibration curves in both the training and validation cohort.

Results: Among the 2,584 younger patients surgically treated for NSCLC meeting the inclusion criteria, the 5-year overall survival (OS) and lung cancer-specific survival (LCSS) rates were 84.3% and 87.0%, respectively. Multivariate analysis identified age, gender, histology, T stage, tumor, node, metastasis (TNM) stage, and postoperative therapy as independent prognosticators. Nomograms exhibited robust predictive performance. The ROC areas for 5-year OS were 0.816 for the training cohort and 0.811 for the validation cohort, while for the 5-year LCSS, the areas were 0.845 and 0.848, respectively. Additionally, the calibration curves demonstrated a high degree of concordance between the actual and predicted values.

Conclusions: We identified the independent survival factors among younger patients treated surgically for NSCLC and established nomograms for the prediction of the long-term survival, offering valuable insights into clinical decision-making for post-surgical treatment.

年轻非小细胞肺癌患者术后生存的预后指标和形态图。
背景:在年轻患者中诊断出的非小细胞肺癌(NSCLC)在肺癌中是一种罕见而独特的实体,但手术治疗的年轻患者的预后指标仍不清楚。我们的目的是分析一个大队列的长期手术结果,确定预测因素,并制定有效的生存预测图。方法:查询监测、流行病学和最终结果(SEER)数据库[2010-2020]中病理证实的接受癌症定向手术的非小细胞肺癌病例。我们选择了49岁或以下的截止年龄来定义年轻队列。生存分析采用Kaplan-Meier法。采用Cox比例风险回归模型确定与生存相关的预后参数。通过训练组和验证组的受试者工作特征(ROC)曲线和校准曲线评估Nomogram绩效。结果:2584例符合入选标准的年轻NSCLC手术患者中,5年总生存率(OS)和肺癌特异性生存率(LCSS)分别为84.3%和87.0%。多变量分析发现,年龄、性别、组织学、T分期、肿瘤、淋巴结、转移(TNM)分期和术后治疗是独立的预后因素。图显示了稳健的预测性能。训练组5年OS的ROC面积为0.816,验证组5年OS的ROC面积为0.811,而5年LCSS的ROC面积分别为0.845和0.848。此外,校正曲线在实际值和预测值之间表现出高度的一致性。结论:我们确定了手术治疗的年轻非小细胞肺癌患者的独立生存因素,并建立了预测长期生存的nomographic,为术后治疗的临床决策提供了有价值的见解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of thoracic disease
Journal of thoracic disease RESPIRATORY SYSTEM-
CiteScore
4.60
自引率
4.00%
发文量
254
期刊介绍: The Journal of Thoracic Disease (JTD, J Thorac Dis, pISSN: 2072-1439; eISSN: 2077-6624) was founded in Dec 2009, and indexed in PubMed in Dec 2011 and Science Citation Index SCI in Feb 2013. It is published quarterly (Dec 2009- Dec 2011), bimonthly (Jan 2012 - Dec 2013), monthly (Jan. 2014-) and openly distributed worldwide. JTD received its impact factor of 2.365 for the year 2016. JTD publishes manuscripts that describe new findings and provide current, practical information on the diagnosis and treatment of conditions related to thoracic disease. All the submission and reviewing are conducted electronically so that rapid review is assured.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信