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Prognostic Nomogram for Overall Survival in Small Cell Lung Cancer Patients Treated with Chemotherapy: A SEER-Based Retrospective Cohort Study

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Abstract

Introduction

Small cell lung cancer (SCLC) is known for its rapid clinical progression and poor prognosis. In this study, we sought to establish a prognostic nomogram among SCLC patients who received chemotherapy.

Methods

We obtained 4971 SCLC patients’ clinical information from the Surveillance, Epidemiology, and End Results (SEER) database for the period between 2004 and 2015. Patients were divided into training and validation sets. Two nomograms were established based on limited stage (LS) and extensive stage (ES) SCLC patients to predict 1-, 2-, and 3-year overall survival (OS) incorporating superior parameters from multivariate Cox regression. Receiver-operating characteristic curves (ROCs) were applied to assess the discrimination ability of the nomogram while the calibration plots were applied to verify the model. Kaplan-Meier method was applied to find survival curves. Decision curve analysis (DCA) was applied to compare OS between the nomograms and 7th American Joint Committee on Cancer (AJCC) tumor node metastasis (TNM) staging system.

Results

Four and six clinical parameters were identified as significant prognostic factors for LS-SCLC and ES-SCLC patient’s OS, respectively. The ROC curves indicated satisfactory discrimination capacity of the nomogram, with 1-, 2-, and 3-year area under curve (AUC) values of 0.89, 0.81, and 0.79 in LS-SCLC patients and 0.71, 0.66, and 0.66 in ES-SCLC patients, respectively. Calibration curves indicated that the nomogram showed good agreement with actual observations in survival rate probability. The survival curves among the LS-SCLC and ES-SCLC cohorts were consistent with the high-risk group having a worse prognosis than the low-risk group. Moreover, ROC and DCA curves showed our nomograms had more benefits than the 7th AJCC-TNM staging system.

Conclusions

We established two nomograms that can present individual predictions of OS among LS-SCLC and ES-SCLC patients who received chemotherapy. These proposed nomograms may aid clinicians in treatment strategy and design of clinical trials.

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Acknowledgements

The authors thank Mrs. Yunru Fan and Dr. Alexandra Lam for coordinating and supporting the development and preparation of the manuscript.

Funding

The funding for this study was provided by the High-level Hospital Construction Project of Maoming People’s Hospital, the Research Project of Maoming Science and Technology Bureau (grant no. 2021121), and the Outstanding Young Talents Program of Maoming People’s Hospital. The Journal’s Rapid Service Fee was funded by the High-level Hospital Construction Project of Maoming People’s Hospital.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Author Contributions

Study concepts: M.L, Study design: M.L and MF.C, Data acquisition: S.S and S.S, Data analysis and interpretation: M.L, Statistical analysis: S.S and S.S, Manuscript preparation: M.L and MF.C, Manuscript editing: Shivank Singh, Manuscript review: Shantanu Singh.

Disclosures

Min Liang, Mafeng Chen, Shantanu Singh, and Shivank Singh all have nothing to disclose.

Compliance with Ethics Guidelines

This article was built on open access databases and does not contain any new researches involving human participants or animals. The protocol for this study was approved by the ethics committee of Maoming People's Hospital. All authors have signed the SEER Research Data Agreement to protect the privacy of patients, which is consistent with ethical principles.

Data Availability Statement

The datasets generated during and/or analyzed during the current study are available in the Surveillance, Epidemiology, and End Results (SEER) repository, [https://seer.cancer.gov/data/].

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Authors and Affiliations

  1. Department of Respiratory and Critical Care Medicine, Maoming People’s Hospital, Maoming, China

    Min Liang

  2. Department of Otolaryngology, Maoming People’s Hospital, Maoming, China

    Mafeng Chen

  3. Division of Pulmonary, Critical Care and Sleep Medicine, Marshall University, Huntington, WV, USA

    Shantanu Singh

  4. Southern Medical University, Guangzhou, China

    Shivank Singh

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  1. Min Liang
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Correspondence to Min Liang.

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Liang, M., Chen, M., Singh, S. et al. Prognostic Nomogram for Overall Survival in Small Cell Lung Cancer Patients Treated with Chemotherapy: A SEER-Based Retrospective Cohort Study. Adv Ther 39, 346–359 (2022). https://doi.org/10.1007/s12325-021-01974-6

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  • DOI: https://doi.org/10.1007/s12325-021-01974-6

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