A Nomogram for Predicting Recurrence in Stage I Non‐Small Cell Lung Cancer

ABSTRACT Background Early‐stage non–small cell lung cancer (NSCLC) is being diagnosed increasingly, and in 30% of diagnosed patients, recurrence will develop within 5 years. Thus, it is urgent to identify recurrence‐related markers to optimize the management of patient‐tailored therapeutics. Methods...

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Main Authors: Rongrong Bian, Feng Zhao, Bo Peng, Jin Zhang, Qixing Mao, Lin Wang, Qiang Chen
Format: Article
Language:English
Published: Wiley 2024-11-01
Series:The Clinical Respiratory Journal
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Online Access:https://doi.org/10.1111/crj.70022
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author Rongrong Bian
Feng Zhao
Bo Peng
Jin Zhang
Qixing Mao
Lin Wang
Qiang Chen
author_facet Rongrong Bian
Feng Zhao
Bo Peng
Jin Zhang
Qixing Mao
Lin Wang
Qiang Chen
author_sort Rongrong Bian
collection DOAJ
description ABSTRACT Background Early‐stage non–small cell lung cancer (NSCLC) is being diagnosed increasingly, and in 30% of diagnosed patients, recurrence will develop within 5 years. Thus, it is urgent to identify recurrence‐related markers to optimize the management of patient‐tailored therapeutics. Methods The eligible datasets were downloaded from TCGA and GEO. In the discovery phase, two algorithms, least absolute shrinkage and selector operation and support vector machine‐recursive feature elimination, were used to identify candidate genes. The recurrence‐associated signature was developed by penalized Cox regression. The nomogram was constructed and further tested via other independent cohorts. Results In this retrospective study, 14 eligible datasets and 7 published signatures were included. A 13‐gene based signature was generated by penalized Cox regression categorized training cohort into high‐risk and low‐risk subgroups (HR = 8.873, 95% CI: 4.228–18.480 p < 0.001). Furthermore, a nomogram integrating the recurrence‐related signature, age, and histology was developed to predict the recurrence‐free survival in the training cohort, which performed well in the two external validation cohorts (concordance index: 0.737, 95% CI: 0.732–0.742, p < 0.001; 0.666, 95% CI: 0.650–0.682, p < 0.001; 0.651, 95% CI: 0.637–0.665, p < 0.001, respectively). The nomogram was further performed well in the Jiangsu cohort enrolled 163 patients (HR = 2.723, 95% CI: 1.526–4.859, p = 0.001). Post‐operative adjuvant therapy achieved evaluated disease‐free survival in high and intermediate risk groups (HR = 4.791, 95% CI: 1.081–21.231, p = 0.039). Conclusions The proposed nomogram is a promising tool for estimating recurrence‐free survival in stage I NSCLC, which might have tremendous value in management of early stage NSCLC and guiding adjuvant therapy strategies.
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spelling doaj-art-202d87a1a55b4a5fb025ab8b69b6e3e72024-11-25T06:08:37ZengWileyThe Clinical Respiratory Journal1752-69811752-699X2024-11-011811n/an/a10.1111/crj.70022A Nomogram for Predicting Recurrence in Stage I Non‐Small Cell Lung CancerRongrong Bian0Feng Zhao1Bo Peng2Jin Zhang3Qixing Mao4Lin Wang5Qiang Chen6Department of Oncology Nanjing Liuhe District People's Hospital Nanjing ChinaDepartment of Thoracic Surgery Taixing People's Hospital Taixing ChinaDepartment of Thoracic Surgery, Xuzhou Central Hospital XuZhou Clinical School of Xuzhou Medical University Xuzhou Jiangsu ChinaDepartment of Oncology, Department of Geriatric Lung Cancer Laboratory The Affiliated Geriatric Hospital of Nanjing Medical University, Jiangsu Province Geriatric Hospital Nanjing ChinaDepartment of Thoracic Surgery, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research Nanjing Medical University Affiliated Cancer Hospital Nanjing ChinaDepartment of Oncology, Department of Geriatric Lung Cancer Laboratory The Affiliated Geriatric Hospital of Nanjing Medical University, Jiangsu Province Geriatric Hospital Nanjing ChinaDepartment of Thoracic Surgery, Xuzhou Central Hospital XuZhou Clinical School of Xuzhou Medical University Xuzhou Jiangsu ChinaABSTRACT Background Early‐stage non–small cell lung cancer (NSCLC) is being diagnosed increasingly, and in 30% of diagnosed patients, recurrence will develop within 5 years. Thus, it is urgent to identify recurrence‐related markers to optimize the management of patient‐tailored therapeutics. Methods The eligible datasets were downloaded from TCGA and GEO. In the discovery phase, two algorithms, least absolute shrinkage and selector operation and support vector machine‐recursive feature elimination, were used to identify candidate genes. The recurrence‐associated signature was developed by penalized Cox regression. The nomogram was constructed and further tested via other independent cohorts. Results In this retrospective study, 14 eligible datasets and 7 published signatures were included. A 13‐gene based signature was generated by penalized Cox regression categorized training cohort into high‐risk and low‐risk subgroups (HR = 8.873, 95% CI: 4.228–18.480 p < 0.001). Furthermore, a nomogram integrating the recurrence‐related signature, age, and histology was developed to predict the recurrence‐free survival in the training cohort, which performed well in the two external validation cohorts (concordance index: 0.737, 95% CI: 0.732–0.742, p < 0.001; 0.666, 95% CI: 0.650–0.682, p < 0.001; 0.651, 95% CI: 0.637–0.665, p < 0.001, respectively). The nomogram was further performed well in the Jiangsu cohort enrolled 163 patients (HR = 2.723, 95% CI: 1.526–4.859, p = 0.001). Post‐operative adjuvant therapy achieved evaluated disease‐free survival in high and intermediate risk groups (HR = 4.791, 95% CI: 1.081–21.231, p = 0.039). Conclusions The proposed nomogram is a promising tool for estimating recurrence‐free survival in stage I NSCLC, which might have tremendous value in management of early stage NSCLC and guiding adjuvant therapy strategies.https://doi.org/10.1111/crj.70022nomogramrecurrencestage I non–small cell lung cancersurvival
spellingShingle Rongrong Bian
Feng Zhao
Bo Peng
Jin Zhang
Qixing Mao
Lin Wang
Qiang Chen
A Nomogram for Predicting Recurrence in Stage I Non‐Small Cell Lung Cancer
The Clinical Respiratory Journal
nomogram
recurrence
stage I non–small cell lung cancer
survival
title A Nomogram for Predicting Recurrence in Stage I Non‐Small Cell Lung Cancer
title_full A Nomogram for Predicting Recurrence in Stage I Non‐Small Cell Lung Cancer
title_fullStr A Nomogram for Predicting Recurrence in Stage I Non‐Small Cell Lung Cancer
title_full_unstemmed A Nomogram for Predicting Recurrence in Stage I Non‐Small Cell Lung Cancer
title_short A Nomogram for Predicting Recurrence in Stage I Non‐Small Cell Lung Cancer
title_sort nomogram for predicting recurrence in stage i non small cell lung cancer
topic nomogram
recurrence
stage I non–small cell lung cancer
survival
url https://doi.org/10.1111/crj.70022
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