Yi Liu, Qirui Chen, Zhirong Zhang, Huandong Huo, Takuya Watanabe, Shuo Chen, Bin Hu
{"title":"年轻非小细胞肺癌患者术后生存的预后指标和形态图。","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":"{\"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}","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}
Prognostic indicators and nomograms for postoperative survival among younger patients with non-small cell lung cancer.
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.
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.
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