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P1.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 948)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Presentations: 1
- Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
P1.16-39 - A Nomogram for Predicting Survival Of TNM8 Stage I Non-Small Cell Lung Cancer Patients to Tailor Potential Chemotherapy Candidates (ID 12463)
16:45 - 18:00 | Author(s): Yuan Zeng
The 8th TNM stage I non–small-cell lung cancer (NSCLC) patients are not considered as candidates for adjuvant chemotherapy (ad-Chemo). This study aimed to develop a nomogram for predicting cancer specific survival (CSS) of these patients and identifying those who might benefit from ad-Chemo.a9ded1e5ce5d75814730bb4caaf49419 Method
NSCLC cases between 1998 and 2013 were extracted from the SEER database and randomly divided into training and validation cohorts. We identified and integrated the recurrence-associated factors to build a nomogram. We determined the cut-off for the high-risk group by matching the nomogram-predicted 5-year CSS with that of the current 4-5 cm stage IIA cases. The difference in benefit from chemotherapy between risk groups was examined using both SEER and NCDB cohort.4c3880bb027f159e801041b1021e88e8 Result
A total of 30,475 patients with stage I were included for analysis. Six independent prognostic factors were identified and integrated into the model. The calibration curves showed good agreement. The C-index of the nomogram was higher than that of the staging system (IA1, IA2, IA3, IB) (training set, 0.59 vs. 0.56, P < 0.01; validation set, 0.62 vs. 0.57, P < 0.01). Specifically, 26.9% stage IB patients (8.1% of all stage I) were categorized into the high-risk group (score>29) and had inferior CSS compared with stage IIA patients. In addition, chemotherapy was associated with significantly better OS (HR, 0.739; P = 0.047) than no-chemotherapy in the high-risk group.
We established a practical and economical nomogram to predict CSS for 8th edition stage I NSCLC, and identified a subset of patients at relatively high risk for recurrence who might benefit from ad-Chemo.6f8b794f3246b0c1e1780bb4d4d5dc53
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