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Prognostic nomogram and novel risk-scoring system for small cell lung cancer with different patterns of metastases

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Abstract

Objective

This research is aimed to develop the prognostic nomogram and novel risk-scoring system for small cell lung cancer (SCLC) with different patterns of metastases.

Methods

Data on SCLC patients were extracted from the 2010–2015 Surveillance, Epidemiology, and End Results (SEER) database. This nomogram prognostic model was confirmed in the validation cohort. C-index and calibration curve were used to evaluate the accuracy of nomogram model. The predictive capability and net benefit of nomogram was estimated by decision curve analysis (DCA). The cut-off point of the risk stratification system based on nomogram was assessed by X-tile analysis.

Results

Our Cox model indicated that age, gender, American Joint Committee on Cancer (AJCC) stage, metastases, chemotherapy, radiation and surgery were independent predictors for OS in SCLC patients. The C-index value of nomogram integrating significant variables for predicting OS in SCLC patients was 0.752 in SEER training set and 0.748 in SEER validation set, respectively. However, the TNM stage only had C-indexes of 0.464 and 0.472 for predicting OS, respectively. The nomogram prognostic model in this study showed higher C-indexes than those in the TNM stage. The C-index value and high quality of calibration plots indicate that the predictive ability of our nomogram model was of great superiority. DCA showed the nomogram had good clinical value. SCLC patients were further divided into low-risk and high-risk group according to nomogram predicted scores.

Conclusion

Our nomogram model that integrated significant factors can aid as an individualized clinical predictive tool in SCLC patients.

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Data availability

Raw data can be accessed in the SEER database. The datasets used and/or analysed data in the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank Xi Liang for helpful advices on the methodology and statistics in this study. Thanks to the SEER Program tumor registries for providing the high-quality resources. Previous version of this article is a preprint in Research Square (https://doi.org/10.21203/rs.3.rs-801014/v1). Preprints have not been peer reviewed.

Funding

This work was supported by the Zhejiang Provincial Natural Science Foundation of China under Grant (LQ20H080003); Medical Health Science and Technology Project of Zhejiang Provincial Health Commission under Grant (2020KY1053).

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Authors and Affiliations

  1. Department of Radiotherapy, Taizhou Central Hospital (Taizhou University Hospital), No. 999 Donghai Road, Taizhou, 318000, Zhejiang, People’s Republic of China

    Huali Sun, Yu Guo, Yan Ding, Yanmei Liu, Shenpeng Ying & Peipei Lin

  2. Department of Emergency Medicine, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, People’s Republic of China

    Hongli Ruan

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  1. Hongli Ruan
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Contributions

PPL and SPY designed the study. HLR arranged the data and wrote the manuscript. YG, YD, YML, HLS and SPY arranged the data.

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Correspondence to Shenpeng Ying or Peipei Lin.

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Ruan, H., Sun, H., Guo, Y. et al. Prognostic nomogram and novel risk-scoring system for small cell lung cancer with different patterns of metastases. Gen Thorac Cardiovasc Surg 70, 1022–1031 (2022). https://doi.org/10.1007/s11748-022-01840-4

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