KEY TAKEAWAYS
- The study aimed to create an easy-to-use survival prediction model incorporating current lymph node status factors.
- The results revealed that post-surgery NSCLC nomogram surpasses the TNM system, aiding clinicians in treatment and control.
The tumor, node, and metastasis stages are widely used to classify lung cancer and guide clinical decisions. However, increasing research indicates this staging system needs more precision regarding the N status.
Xiaoping Lin and the team aimed to develop a user-friendly survival prediction model that incorporates current lymph node status parameters.
Researchers collected data from 2006 to 2015 using the Surveillance, Epidemiology, and End Results database from individuals with resectable nonsmall cell lung cancer (NSCLC) (IA-IIIB).
They utilized the x-tile program to determine the optimal threshold for the metastatic lymph node ratio (MLNR). Independent prognostic factors were identified through multivariable Cox regression analysis and used to construct a nomogram model. The model’s accuracy was assessed using a calibration curve and the Concordance Index (C-index).
Based on their risk points, patients were categorized into three risk levels. The prognostic value of MLNR and examined lymph node numbers (ELNs) were analyzed within subgroups.
The study analyzed data from 40,853 individuals with NSCLC after surgery. Multivariable Cox regression analysis identified age, metastatic lymph node ratio (MLNR), histology type, adjuvant treatment, and the American Joint Committee on Cancer (AJCC) 8th T stage as independent prognostic factors.
A nomogram was constructed using these variables, demonstrating superior efficiency in predicting patient survival compared to the conventional AJCC stage system. The new model showed a significantly higher Concordance Index (C-index) (training set: 0.683 vs. 0.641, P< 0.01; testing set: 0.676 vs. 0.638, P< 0.05).
The calibration curve also indicated that the nomogram better matched actual observations in both cohorts. Following risk stratification, MLNR proved more reliable than the number of examined lymph nodes (ELNs) in predicting overall survival.
The study concluded that a newly developed nomogram model for patients with NSCLC after surgery outperforms the widely used tumor, node, and metastasis staging system. This novel tool could significantly benefit clinicians in treatment planning and cancer control.
No funding information was available.
Source: https://pubmed.ncbi.nlm.nih.gov/38842873/
Lin X, Yao J, Huang B, et al. (2024). “Significance of metastatic lymph nodes ratio in overall survival for patients with resected nonsmall cell lung cancer: a retrospective cohort study.” Eur J Cancer Prev. 2024 Jul 1;33(4):376-385. doi: 10.1097/CEJ.0000000000000868. Epub 2024 May 16. PMID: 38842873.
