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Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
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A Nomogram for Predicting Brain Metastasis in IIIA-N2 Non-Small Cell Lung Cancer After Complete Resection: A

Shuang Sun1, Yu Men1,2, Jingjing Kang1

  • 1Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Frontiers in Oncology
|December 30, 2021
PubMed
Summary
This summary is machine-generated.

This study identifies risk factors for brain metastasis (BM) in non-small cell lung cancer (NSCLC) patients after surgery. A predictive nomogram helps select patients who may benefit from prophylactic cranial irradiation (PCI).

Keywords:
brain metastasiscompeting risk analysiscomplete resectionnomogramnon-small cell lung cancer

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Area of Science:

  • Oncology
  • Radiotherapy
  • Surgical Oncology

Background:

  • Brain metastasis (BM) is a common complication in stage IIIA-N2 non-small cell lung cancer (NSCLC) post-resection.
  • Prophylactic cranial irradiation (PCI) improves intracranial control but not overall survival in these patients.
  • Identifying BM risk factors is crucial for optimizing PCI selection.

Purpose of the Study:

  • To identify independent risk factors for BM in completely resected stage IIIA-N2 NSCLC.
  • To develop a predictive nomogram for BM risk.
  • To aid in selecting patients who may benefit from PCI.

Main Methods:

  • Retrospective review of 517 patients with stage IIIA-N2 NSCLC undergoing complete resection (2011-2014).
  • Fine and Gray's competing risk analysis to build a nomogram predicting 1-, 3-, and 5-year BM probabilities.
  • Validation using receiver operating characteristic and calibration curves.

Main Results:

  • Multivariate analysis identified non-squamous cell carcinoma, bronchial invasion, perineural invasion, and adjuvant chemotherapy as independent risk factors for BM.
  • The developed nomogram demonstrated good predictive accuracy (Area Under Curve = 0.767).
  • 1-, 3-, and 5-year BM rates were 5.4%, 15.7%, and 22.2%, respectively.

Conclusions:

  • A nomogram incorporating clinicopathological factors and treatment was developed to predict BM in stage IIIA-N2 NSCLC.
  • This tool can help screen high-risk patients who might benefit from PCI.