A nomogram to predict prognosis after surgery in early stage non-small cell lung cancer in elderly patients

The aim of this study was to identify risk factors affecting overall survival (OS) of elderly patients with early stage NSCLC, and develop a nomogram for prognostic prediction of these patients using data from the Surveillance, Epidemiology, and End Results (SEER) database.

Data from the SEER database of patients aged ≥ 65 years with early (T1N0M0) NSCLC diagnosed between 2004 and 2013 were examined. The prognostic effect of each variable on survival was evaluated using the Kaplan-Meier method and the Cox proportional hazards regression model. A nomogram was formulated to predict the 3- and 5-year OS rates of elderly patients with early stage NSCLC.

Finally, a total of 20,782 patients were included in this research. Cox regression analysis showed that sex, age, pathological type, diameter, differentiation, and surgery type were independent risk factors. A nomogram was formulated based on the results of multivariate analysis (all p < 0.001) and validated using an internal bootstrap resampling approach, which showed that the nomogram exhibited a sufficient level of discrimination according to the C-index (0.638, 95% CI = 0.629-0.647).

The nomogram developed in this study demonstrated its discrimination capability to predict the 3- and 5-year OS rates of elderly patients with early stage NSCLC based on individual characteristics.