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Xiaoyu Zhai

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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
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.16-62 - A Nomogram to Predict Disease-Free Survival After Curative Resection of Non-Small Cell Lung Cancer (ID 11913)

      16:45 - 18:00  |  Author(s): Xiaoyu Zhai

      • Abstract
      • Slides


      The aim of this study was to find clinicopathologic variables associated with disease-free survival (DSF) and develop a prognostic nomogram for patients with curative resected non-small-cell lung cancer (NSCLC) and compare the value of the nomogram to the seventh AJCC TNM classification.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      A nomogram to predict DFS following surgical resection of NSCLC was constructed using a single-institutional cohort of 805 patients who underwent curative resection of lung adenocarcinoma in the Cancer Hospital of the Chinese Academy of Medical Sciences (Beijing, China) between January 2003 and December 2013. For nomogram construction and validation, we randomly assigned two thirds of the patients to the training cohort (n=605) and one third to the validation cohort (n=260). The median age of training cohort was 57 years (range, 25-76) and the proportion of male and female patients was 64.8% vs. 35.2%. Half of the patients (49.8%) presented with early-stage disease and 85.3% patients received adjuvant chemotherapy alone. The predictive discriminative and calibration were measured by concordance index (C-index), risk group stratification and calibration plot.

      4c3880bb027f159e801041b1021e88e8 Result

      The median disease-free survival for the total cohort was 23.2 months (95% CI, 21.3-26.4 months). The 1-, 3- and 5-year disease-free survival was 71.3%, 39.5% and 32.3%, respectively. The nomogram included 8 important variables based on a Cox proportional hazards regression modeling of the training cohort: histology, differentiation, nodal status, AJCC T category, primary tumor location, type of surgical resection, adjuvant radiotherapy and regimen. Each patient with a higher score had a worse prognosis. Prognostic discrimination was performed by dividing the predicted nomogram score into quartiles that were then used to plot Kaplan-Meier curves. The nomogram was able to stratify patients into 4 distinct incremental 3-year prognostic groups (quartile 1, 73.0%; quartile 2, 49.6%; quartile 3, 30.6%; and quartile 4, 9.3% [P <0.001]). Both in the training and validation cohort, the C-index of the nomogram for DFS prediction was superior to the TNM category prediction (training cohort, 0.694 vs. 0.640; P<0.01 and validation cohort, 0.662 vs. 0.602; P<0.01). The 200-sample bootstrapped calibration curves for probability of 3- and 5-year disease-free survival (PFS) showed optimal agreement between nomogram prediction and actual observation.

      8eea62084ca7e541d918e823422bd82e Conclusion

      This novel nomogram provides an individualized prediction of DFS in NSCLC patients after radical surgery and may assist the clinical treatment decision making and clinical trials designing.


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