Prognostic nomograms for lung neuroendocrine carcinomas based on lymph node ratio: a SEER database analysis
Lan Xiong1, Youfan Jiang1, Tianyang Hu2
1Department of Respiration, 585250The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
The Journal of International Medical Research
|September 9, 2022
Summary
The lymph node ratio (LNR) improves prognostic accuracy for lung neuroendocrine carcinomas (LNECs). Nomograms incorporating LNR offer superior prediction of overall survival (OS) and lung cancer-specific survival (LCSS) compared to current staging systems.
Area of Science:
- Oncology
- Cancer Research
- Medical Statistics
Background:
- Lung neuroendocrine carcinomas (LNECs) are rare tumors.
- Accurate prognostic assessment is crucial for guiding treatment decisions in LNEC patients.
Purpose of the Study:
- To evaluate the prognostic significance of the lymph node ratio (LNR) in patients diagnosed with LNECs.
- To develop and validate prognostic nomograms incorporating LNR for LNECs.
Main Methods:
- Utilized data from 1564 elderly LNEC patients (1998-2016) from the Surveillance, Epidemiology, and End Results (SEER) database.
- Randomly assigned data into training (n=1086) and validation (n=478) sets.
- Employed Cox regression analysis to assess the association between LNR and survival outcomes (OS, LCSS).
Main Results:
- Multivariate analysis identified LNR, age, tumor grade, summary stage, M stage, and surgery as independent prognostic factors for OS and LCSS.
- Tumor size was also a significant predictor for LCSS.
- Developed prognostic nomograms integrating LNR demonstrated strong discrimination and calibration, outperforming the AJCC staging system (C-index comparison).
Conclusions:
- Nomograms based on LNR provide enhanced prognostic predictive accuracy for overall survival and lung cancer-specific survival in LNEC patients.
- The LNR-based nomograms represent a valuable tool for more precise prognostication compared to the established AJCC staging system.
