Prognostic analysis and clinical characteristics of dual primary lung cancer: a population study based on surveillance, epidemiology, and end results (SEER) database

列线图 医学 比例危险模型 肿瘤科 内科学 肺癌 接收机工作特性 监测、流行病学和最终结果 阶段(地层学) 单变量 回顾性队列研究 流行病学 多元统计 统计 癌症登记处 生物 数学 古生物学
作者
Guanghui Wang,Yukai Zeng,Haotian Zheng,Xiaogang Zhao,Yadong Wang,Hongchang Shen,Jiajun Du
出处
期刊:General thoracic and cardiovascular surgery [Springer Science+Business Media]
卷期号:70 (8): 740-749 被引量:2
标识
DOI:10.1007/s11748-022-01795-6
摘要

The peculiarity and the lack of clinical studies of dual primary lung cancer (DPLC) led to limited knowledge about its clinical characteristics and prognosis. This study performed a retrospective analysis to assess the prognostic factors and clinical characteristics of DPLC. A total of 1419 DPLC patients from SEER were analyzed by univariate and multivariable Cox regression analyses. The independent prognostic factors were included to establish a nomogram. The accuracy and reliability of prognostic model were evaluated by C indexes, calibration plots, receiver operating characteristic (ROC) curves, decision curve analyses (DCA) and integrated discrimination improvement (IDI) scores. Chi-square test was used to assess the differences between DPLC and single primary lung cancer (SPLC) or synchronous DPLC (sDPLC) and metachronous DPLC (mDPLC). Cox regression analysis showed that age, sex, histological type, stage, lymph node (LN) metastasis, surgery, chemotherapy were independent prognostic factors, we included these factors to establish a nomogram. In the training cohort, the C index was 0.690, and the area under curves (AUC) of 3 and 5-year survival time were 0.720 and 0.723. The calibration plots in training cohort and validation cohort were in excellent agreement. DCA and IDI showed that the predictive effect of the novel prognostic model was better than the model based on 8th AJCC TNM system. Chi-square test indicated that DPLC and SPLC had statistical differences on pathological and clinical features. The clinical and pathological characteristics of DPLC were different from the SPLC. The nomogram could provide accurate and individualized survival predictions for DPLC.
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