Development and validation of a novel nomogram to predict the overall survival of patients with large cell lung cancer: A surveillance, epidemiology, and end results population-based study

Hongxia Zhou; Pengxiang Gao; Fangpeng Liu; Liangliang Shi; Longhua Sun; Wei Zhang; Xinping Xu; Xiujuan Liu

doi:10.1016/j.heliyon.2023.e15924

Development and validation of a novel nomogram to predict the overall survival of patients with large cell lung cancer: A surveillance, epidemiology, and end results population-based study

Heliyon. 2023 May 6;9(5):e15924. doi: 10.1016/j.heliyon.2023.e15924. eCollection 2023 May.

Authors

Hongxia Zhou¹, Pengxiang Gao², Fangpeng Liu², Liangliang Shi³, Longhua Sun², Wei Zhang^{2

4

5}, Xinping Xu^{2

4

5}, Xiujuan Liu¹

Affiliations

¹ Department of Nephrology, The 908th Hospital of the People's Liberation Army Joint Logistics Support Force, The Great Wall Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi 330006, China.
² Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province 330006, China.
³ Medical Center of Burn Plastic and Wound Repair, The First Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province 330006, China.
⁴ Jiangxi Institute of Respiratory Diseases, The First Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province 330006, China.
⁵ Jiangxi Clinical Research Center for Respiratory Diseases, The First Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province 330006, China.

Abstract

Background: Large cell lung cancer (LCLC) is a rare subtype of non-small cell lung carcinoma (NSCLC), and little is known about its clinical and biological characteristics.

Methods: LCLC patient data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. All patients were randomly divided into a training group and a validation group at a ratio of 7:3. The independent prognostic factors that were identified (P < 0.01) by stepwise multivariate Cox analysis were incorporated into an overall survival (OS) prediction nomogram, and risk-stratification systems, C-index, time-ROC, calibration curve, and decision curve analysis (DCA) were applied to evaluate the quality of the model.

Results: Nine factors were incorporated into the nomogram: age, sex, race, marital status, 6th AJCC stage, chemotherapy, radiation, surgery and tumor size. The C-index of the predicting OS model in the training dataset and in the test dataset was 0.757 ± 0.006 and 0.764 ± 0.009, respectively. The time-AUCs exceeded 0.8. The DCA curve showed that the nomogram has better clinical value than the TNM staging system.

Conclusions: Our study summarized the clinical characteristics and survival probability of LCLC patients, and a visual nomogram was developed to predict the 1-year, 3-year and 5-year OS of LCLC patients. This provides more accurate OS assessments for LCLC patients and helps clinicians make personal management decisions.

Keywords: Large cell lung cancer; Nomogram; Overall survival; Prognostic.