Skip to main content
SpringerLink
Log in

Development and Validation of a Nomogram for Predicting the 1-, 3-, and 5-year Survival in Patients with Acinar-predominant Lung Adenocarcinoma

  • Published:
Current Medical Science Aims and scope Submit manuscript

Abstract

Objective

This study aimed to develop a nomogram to predict the overall survival (OS) of patients with acinar-predominant adenocarcinoma (APA).

Methods

Data from patients with APA obtained from the Surveillance, Epidemiology, and End Results (SEER) database between 2008 and 2016 were used. Significant prognostic factors were incorporated to construct a nomogram for predicting the 1-, 3-, and 5-year OS in these patients. The discrimination and calibration abilities of the nomogram were assessed using a C-index and calibration curves, respectively.

Results

A total of 2242 patients with APA were randomly divided into a training cohort (n=1576) and validation cohort (n=666). The independent prognostic factors for OS incorporated into the nomogram included marital status, age, gender, differentiation grade, T stage, N stage, and M stage. The nomogram showed good prediction capability, as indicated by the C-index [0.713, 95% confidence interval (CI): 0.705–0.721 in the training cohort, and 0.662, 95% CI: 0.649–0.775 in the validation cohort]. The calibration curves demonstrated that the 1-, 3-, and 5-year OS probabilities were consistent between the observed and predicted outcome frequencies. Patients were divided into the high-risk and low-risk groups with the former showing significantly worse survival than the latter (P<0.001).

Conclusion

Using the SEER database, a nomogram was established to predict the 1-, 3-, and 5-year OS of patients with APA and was superior to the tumor size, lymph node, and metastasis staging system in terms of evaluating long-term prognosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Travis WD, Brambilla E, Nicholson AG, et al. The 2015 World Health Organization Classification of Lung Tumors: Impact of Genetic, Clinical and Radiologic Advances Since the 2004 Classification. J Thorac Oncol, 2015,10(9):1243–1260

    Article  Google Scholar 

  2. Lantuejoul S, Rouquette I, Brambilla E, et al. New WHO classification of lung adenocarcinoma and preneoplasia. Ann Pathol,2016,36(1):5–14

    Article  Google Scholar 

  3. Tsao MS, Marguet S, Le Teuff G, et al. Subtype Classification of Lung Adenocarcinoma Predicts Benefit From Adjuvant Chemotherapy in Patients Undergoing Complete Resection. J Clin Oncol, 2015,33(30):3439–3346

    Article  Google Scholar 

  4. Ito M, Miyata Y, Tsutani Y, et al. Positive EGFR mutation status is a risk of recurrence in pN0-1 lung adenocarcinoma when combined with pathological stage and histological subtype: A retrospective multi-center analysis. Lung Cancer, 2020,141:107–113

    Article  Google Scholar 

  5. Mansuet-Lupo A, Bobbio A, Blons H, et al. The new histologic classification of lung primary adenocarcinoma subtypes is a reliable prognostic marker and identifies tumors with different mutation status: the experience of a French cohort. Chest, 2014,146(3):633–643

    Article  Google Scholar 

  6. Yanagawa N, Shiono S, Abiko M, et al. New IASLC/ATS/ERS classification and invasive tumor size are predictive of disease recurrence in stage I lung adenocarcinoma. J Thorac Oncol, 2013,8(5):612–618

    Article  Google Scholar 

  7. Li C, Shen Y, Hu F, et al. Micropapillary pattern is associated with the development of brain metastases and the reduction of survival time in EGFR-mutation lung adenocarcinoma patients with surgery. Lung Cancer, 2020,141:72–77

    Article  Google Scholar 

  8. Ma M, She Y, Ren Y, et al. Micropapillary or solid pattern predicts recurrence free survival benefit from adjuvant chemotherapy in patients with stage IB lung adenocarcinoma. J Thorac Dis, 2018,10(9):5384–5393

    Article  Google Scholar 

  9. Yaldız D, Acar A, Örs Kaya Ş, et al. Papillary predominant histological subtype predicts poor survival in lung adenocarcinoma. Turk Gogus Kalp Damar Cerrahisi Derg, 2019,27(3):360–366

    Article  Google Scholar 

  10. Yoshizawa A, Sumiyoshi S, Sonobe M, et al. Validation of the IASLC/ATS/ERS lung adenocarcinoma classification for prognosis and association with EGFR and KRAS gene mutations: analysis of 440 Japanese patients. J Thorac Oncol, 2013,8(1):52–61

    Article  Google Scholar 

  11. Ito H, Nakayama H, Murakami, et al. Does the histologic predominance of pathological stage IA lung adenocarcinoma influence the extent of resection? Gen Thorac Cardiovasc Surg, 2017,65(9):512–518

    Article  Google Scholar 

  12. Zombori T, Furák J, Nyári T, et al. Evaluation of grading systems in stage I lung adenocarcinomas: a retrospective cohort study. J Clin Pathol, 2018,71(2):135–140

    Article  Google Scholar 

  13. Moreira AL, Ocampo PSS, Xia Y, et al. A Grading System for Invasive Pulmonary Adenocarcinoma: A Proposal From the International Association for the Study of Lung Cancer Pathology Committee. J Thorac Oncol, 2020,15(10):1599–1610

    Article  Google Scholar 

  14. Ito M, Miyata Y, Yoshiya T, et al. Second predominant subtype predicts outcomes of intermediate-malignant invasive lung adenocarcinoma. Eur J Cardiothorac Surg, 2017,51(2):218–222

    Google Scholar 

  15. Li H, Wang Z, Yang F, et al. Development and validation of a nomogram for predicting cancer-specific survival of surgical resected stage I–II adenosquamous carcinoma of the lung. J Surg Oncol, 2020,121(6):1027–1035

    Article  Google Scholar 

  16. Zeng Y, Mayne N, Yang CJ, et al. A Nomogram for Predicting Cancer-Specific Survival of TNM 8th Edition Stage I Non-small-cell Lung Cancer. Ann Surg Oncol, 2019,26(7):2053–2062

    Article  Google Scholar 

  17. Iasonos A, Schrag D, Raj GV, et al. How to build and interpret a nomogram for cancer prognosis. J Clin Oncol, 2008,26(8):1364–1370

    Article  Google Scholar 

  18. Shariat SF, Karakiewicz PI, Suardi N, et al. Comparison of nomograms with other methods for predicting outcomes in prostate cancer: a critical analysis of the literature. Clin Cancer Res, 2008,14(14):4400–4407

    Article  Google Scholar 

  19. Heagerty PJ, Lumley T, Pepe MS. Time-dependent ROC curves for censored survival data and a diagnostic marker. Biometrics, 2000,56(2):337–344

    Article  Google Scholar 

  20. Pencina MJ, D’Agostino RB, Sr., D’Agostino RB, Jr., et al. Evaluating the added predictive ability of a new marker: from area under the ROC curve to reclassification and beyond. Stat Med, 2008,27(2):157–172

    Article  Google Scholar 

  21. Vickers AJ, Elkin EB. Decision curve analysis: a novel method for evaluating prediction models. Med Decis Making, 2006,26(6):565–574

    Article  Google Scholar 

  22. Mackinnon AC, Jr., Luevano A, de Araujo LC, et al. Cribriform adenocarcinoma of the lung: clinicopathologic, immunohistochemical, and molecular analysis of 15 cases of a distinctive morphologic subtype of lung adenocarcinoma. Mod Pathol, 2014,27(8):1063–1072

    Article  Google Scholar 

  23. Kim M, Chung YS, Kim KA, et al. Prognostic factors of acinar- or papillary-predominant adenocarcinoma of the lung. Lung Cancer, 2019,137:129–135

    Article  Google Scholar 

  24. Lu D, Yang J, Liu X, et al. Clinicopathological features, survival outcomes, and appropriate surgical approaches for stage I acinar and papillary predominant lung adenocarcinoma. Cancer Med, 2020,9(10):3455–3462

    Article  Google Scholar 

  25. Suzuki K, Saji H, Aokage K, et al. Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial. J Thorac Cardiovasc Surg, 2019,158(3):895–907

    Article  Google Scholar 

  26. Wen Z, Zhao Y, Fu F, et al. Comparison of outcomes following segmentectomy or lobectomy for patients with clinical N0 invasive lung adenocarcinoma of 2 cm or less in diameter. J Cancer Res Clin Oncol, 2020,146(6):1603–1613

    Article  Google Scholar 

  27. Cao S, Teng J, Xu J, et al. Value of adjuvant chemotherapy in patients with resected stage IB solid predominant and solid non-predominant lung adenocarcinoma. Thorac Cancer, 2019,10(2):249–255

    Article  Google Scholar 

  28. Wang C, Yang J, Lu M. Micropapillary Predominant Lung Adenocarcinoma in Stage IA Benefits from Adjuvant Chemotherapy. Ann Surg Oncol, 2020,27(6):2051–2060

    Article  Google Scholar 

Download references

Author information

Author notes

  1. The authors contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Xiangtan Central Hospital, Xiangtan, 411000, China

    Zhi-chao Zuo, Xiong Li, Zhi Zhong, Huan-ming Zhang & Xin Ouyang

  2. Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China

    Li-de Wang & Qi Xue

  3. Department of Spine Surgery, the Second Xiangya Hospital, Central South University, Changsha, 410011, China

    Ke Peng

  4. Department of Plastic Surgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441000, China

    Jing Yang

Authors
  1. Zhi-chao Zuo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Li-de Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ke Peng
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jing Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Xiong Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Zhi Zhong
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Huan-ming Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Xin Ouyang
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Qi Xue
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Xin Ouyang or Qi Xue.

Ethics declarations

The authors declare that they have no competing interests.

Additional information

This study was supported in part by the National Key Research and Development Program of China (No. 2016YFC1303201).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zuo, Zc., Wang, Ld., Peng, K. et al. Development and Validation of a Nomogram for Predicting the 1-, 3-, and 5-year Survival in Patients with Acinar-predominant Lung Adenocarcinoma. CURR MED SCI 42, 1178–1185 (2022). https://doi.org/10.1007/s11596-022-2672-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11596-022-2672-7

Key words

Search

Navigation