Abstract
BackgroundLarge cell neuroendocrine carcinoma (LCNEC) is a rare and typically aggressive malignancy with poor prognosis. This study developed a nomogram model to predict the overall survival (OS) of patients with LCNEC.MethodsLCNEC patients were identified from the Surveillance, Epidemiology, and End Results database between 2004–2014. Univariate and multivariate Cox regression models were used to determine demographic and clinicopathological features associated with OS. A nomogram model was generated to predict OS and its performance was assessed by Harrell’s concordance index (C-index), calibration plots, and subgroup analysis by risk scores.ResultsOf 3048 eligible patients with LCNEC, 2138 were randomly grouped into the training set and 910 into the validation set. Age at diagnosis, gender, tumor stage, N stage, tumor size, and surgery of primary site were independent prognostic factors of OS. C-index values of the nomogram were 0.75 (95% CI, 0.74–0.76) and 0.76 (95% CI, 0.74–0.77) in the training and validation sets, respectively. In both cohorts, the calibration plots showed good concordance between the predicted and observed OS at 3 and 5 years. Kaplan-Meier curves revealed significant differences in OS in patients stratified by nomogram-based risk score, and patients with a higher-than-median risk score had poorer OS.ConclusionThis is the first nomogram developed and validated in a large population-based cohort for predicting OS in patients with LCNEC, and it shows favorable discrimination and calibration abilities. Use of this proposed nomogram has the potential to improve prediction of survival risk, and lead to individualized clinical decisions for LCNEC.
Highlights
Large cell neuroendocrine carcinoma (LCNEC) of the lung is a rare malignant tumor accounting for only 2 to 3% of all primary lung cancers and carries an aggressive clinical behavior and poor prognosis [1]
concordance index (C-index) values of the nomogram were 0.75 and 0.76 in the training and validation sets, respectively
Kaplan-Meier curves revealed significant differences in overall survival (OS) in patients stratified by nomogram-based risk score, and patients with a higher-than-median risk score had poorer OS
Summary
Large cell neuroendocrine carcinoma (LCNEC) of the lung is a rare malignant tumor accounting for only 2 to 3% of all primary lung cancers and carries an aggressive clinical behavior and poor prognosis [1]. Previously regarded as a subgroup of large cell carcinoma [2], LCNEC was pathologically reclassified in 2015 as a high-grade neuroendocrine tumor, comprising the subgroups small cell lung cancer, typical carcinoid, and atypical carcinoid [3]. Small cell lung cancer is considered the same clinical entity and treated with the conventional chemotherapeutic regimen, these patients are heterogeneous in terms of survival, and no accurate indicator of prognosis has been established [6]. Large cell neuroendocrine carcinoma (LCNEC) is a rare and typically aggressive malignancy with poor prognosis. This study developed a nomogram model to predict the overall survival (OS) of patients with LCNEC
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.
