Abstract
BackgroundFor different lymph node metastasis (LNM) and distant metastasis (DM), the diagnosis, treatment and prognosis of T1-2 non-small cell lung cancer (NSCLC) are different. It is essential to figure out the risk factors and establish prediction models related to LNM and DM.MethodsBased on the surveillance, epidemiology, and end results (SEER) database from 1973 to 2015, a total of 43,156 eligible T1-2 NSCLC patients were enrolled in the retrospective study. Logistic regression analysis was used to determine the risk factors of LNM and DM. Risk factors were applied to construct the nomograms of LNM and DM. The predictive nomograms were discriminated against and evaluated by Concordance index (C-index) and calibration plots, respectively. Decision curve analysis (DCAs) was accepted to measure the clinical application of the nomogram. Cumulative incidence function (CIF) was performed further to detect the prognostic role of LNM and DM in NSCLC-specific death (NCSD).ResultsEight factors (age at diagnosis, race, sex, histology, T-stage, marital status, tumor size, and grade) were significant in predicting LNM and nine factors (race, sex, histology, T-stage, N-stage, marital status, tumor size, grade, and laterality) were important in predicting DM(all, P< 0.05). The calibration curves displayed that the prediction nomograms were effective and discriminative, of which the C-index were 0.723 and 0.808. The DCAs and clinical impact curves exhibited that the prediction nomograms were clinically effective.ConclusionsThe newly constructed nomograms can objectively and accurately predict LNM and DM in patients suffering from T1-2 NSCLC, which may help clinicians make individual clinical decisions before clinical management.
Highlights
Lung cancer is one of the most common malignant tumors
43,156 patients diagnosed with T1-2 non-small cell lung cancer (NSCLC) during 2010-2015 were included in this study from the SEER database
The results proved that positive lymph node involvement (hazard ratio (HR) = 2.96, 95%CI = (2.873.05), P < 0.001) and distant metastasis (HR = 5.50, 95%CI = (5.32-5.68), P < 0.001) are significantly correlated with overall survival using Kaplan-Meier curves (Figures 7A, B)
Summary
Lung cancer is one of the most common malignant tumors. In terms of patients with newly diagnosed pulmonary space occupying lesions, if they are suspected of malignant tumor, percutaneous biopsy, bronchoscopy, sputum cytology, and other methods will be adopted to clarify the pathology before the operation. For the clinical suspected 2R/2L, 4R/4L, and 10R/10L regional lymph node metastasis, the guidelines recommend esophageal ultrasound-guided biopsy. Some thoracic surgeons did not carry out this evaluation before the operation, while performed lymph node biopsy or dissection according to experience. As for whether there are lymph nodes and distant metastasis or not, the results of the prognosis of T1-2 NSCLC are entirely different. For different lymph node metastasis (LNM) and distant metastasis (DM), the diagnosis, treatment and prognosis of T1-2 non-small cell lung cancer (NSCLC) are different.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
