Development and validation of a nomogram for predicting the overall survival of patients with lung large cell neuroendocrine carcinoma.

Abstract

BackgroundLung large cell neuroendocrine carcinoma (L-LCNEC) is a rare and rapidly progressing lung cancer. We aimed to formulate a nomogram model to predict the survival of L-LCNEC patients.MethodsClinical data of patients with L-LCNEC, lung large cell cancer (L-LCC) and small cell lung cancer (SCLC) were derived from the Surveillance, Epidemiology, and End Results (SEER) database. The characteristics and prognosis of L-LCNEC were investigated by comparing with that of L-LCC and SCLC, respectively. All L-LCNEC patients were randomly assigned into training group and validation group. A prognostic nomogram model was established for the overall survival (OS) in L-LCNEC patients. Furthermore, we enrolled 112 L-LCNEC patients from our department to validate the nomogram model.Result3,076 L-LCNEC, 11,163 L-LCC, and 78,097 SCLC patients were collected and enrolled in our analyses. Compared with L-LCC and SCLC, differences were observed in L-LCNEC in age, sex, race, marital status, SEER registry, TNM stage, and treatment. Furthermore, higher proportions of L-LCNEC were located at the upper lobe and unilateral lung compared with SCLC. L-LCNEC has similar survival to L-LCC, but better than SCLC. We identified that the age, gender, T, N, and M classification, and treatment were the independent prognostic predictors. A nomogram model was formulated to predict the OS. Calibration curves were performed to show optimal coherence between predicted probability of survival and actual survival, with a concordance index of 0.775. The external cohort included 112 patients and all of them underwent surgical treatment. The external validation demonstrated the reliability of this model.ConclusionsThe nomogram demonstrated its discrimination capability to predict the OS for L-LCNEC patients.