Based on the Development and Verification of a Risk Stratification Nomogram: Predicting the Risk of Lung Cancer-Specific Mortality in Stage IIIA-N2 Unresectable Large Cell Lung Neuroendocrine Cancer Compared With Lung Squamous Cell Cancer and Lung...

Overview

Journal Front Oncol

Specialty Oncology

Date 2022 Jul 18

PMID 35847910

Authors

Ying Yang

Cheng Shen

Jingjing Shao

Yilang Wang

Gaoren Wang

Aiguo Shen

Affiliations

Soon will be listed here.

Abstract

Background: The purpose of this study is to predict overall survival (OS) and lung cancer-specific survival (LCSS) in patients with stage IIIA-N2 unresectable lung squamous cell cancer (LUSC), lung adenocarcinoma (LUAD), and large cell neuroendocrine cancer (LCNEC) by constructing nomograms and to compare risk and prognostic factors affecting survival outcomes in different histological subtypes.

Methods: We included 11,505 unresectable NSCLC patients at stage IIIA-N2 between 2010 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database. Moreover, competition models and nomograms were developed to predict prognostic factors for OS and LCSS.

Results: Analysis of the SEER database identified 11,505 NSCLC patients, of whom 5,559 (48.3%) have LUAD, 5,842 (50.8%) have LUSC, and 104 (0.9%) have LCNEC. Overall, both OS and LCSS were significantly better in stage IIIA-N2 unresectable LUAD than in LCNEC, while there was no statistically significant difference between LUSC and LCNEC. Age, gender, T stage, chemotherapy, and radiotherapy were significantly associated with OS rates in LUAD and LUSC. However, chemotherapy was the only independent factor for LCNEC ( < 0.01).From competitive risk models, we found that older age, larger tumors, non-chemotherapy and non-radiotherapy were associated with a increased risk of death from LUAD and LUSC. Unlike prognostic factors for OS, our study showed that both chemotherapy and radiotherapy were all LCNEC-specific survival factors for both LCSS and non-LCSS LCNEC.

Conclusion: Our study reports that unresectable patients with stage IIIA-N2 LCNEC and LUSC have worse LCSS than LUAD. The study's first prognostic nomogram constructed for patients with unresectable stage IIIA-N2 NSCLC can accurately predict the survival of different histological types, which may provide a practical tool to help clinicians assess prognosis and stratify these prognostic risks to determine which patients should be given an optimized individual treatment strategy based on histology.

Citing Articles

Identifying the key hub genes linked with lung squamous cell carcinoma by examining the differentially expressed and survival genes.

Chawhan A, Dsouza N Mol Genet Genomics. 2024; 299(1):76.

PMID: 39097557 DOI: 10.1007/s00438-024-02169-8.

Prognostic value analysis and survival model construction of different treatment methods for advanced intestinal type gastric adenocarcinoma.

Liu S, Zhuang Y, Fu Q, Zhang Z, Hang K, Tao T Heliyon. 2024; 10(11):e32238.

PMID: 38912455 PMC: 11190592. DOI: 10.1016/j.heliyon.2024.e32238.

A novel iTreg-related signature for prognostic prediction in lung adenocarcinoma.

Zhang J, Li Y, Yang Y, Huang J, Sun Y, Zhang X Cancer Sci. 2023; 115(1):109-124.

PMID: 38015097 PMC: 10823293. DOI: 10.1111/cas.16015.

Development and validation of a nomogram for predicting overall survival in patients with stage III-N2 lung adenocarcinoma based on the SEER database.

Zhang S, Xiao X, Qin X, Xia H Transl Cancer Res. 2023; 12(10):2742-2753.

PMID: 37969392 PMC: 10643949. DOI: 10.21037/tcr-22-2757.

Development and Validation of Prognostic Nomograms for Lung Squamous Cell Carcinoma With Brain Metastasis in Patients Aged 45 Years or Older: A Population-Based Study.

Yang F, Gao L, Wang Q, Gao W Cancer Control. 2023; 30:10732748231202953.

PMID: 37776257 PMC: 10542326. DOI: 10.1177/10732748231202953.

References

Eberle A, Jansen L, Castro F, Krilaviciute A, Luttmann S, Emrich K . Lung cancer survival in Germany: A population-based analysis of 132,612 lung cancer patients. Lung Cancer. 2015; 90(3):528-33. DOI: 10.1016/j.lungcan.2015.10.007. View

Avanzo M, Gagliardi V, Stancanello J, Blanck O, Pirrone G, El Naqa I . Combining computed tomography and biologically effective dose in radiomics and deep learning improves prediction of tumor response to robotic lung stereotactic body radiation therapy. Med Phys. 2021; 48(10):6257-6269. PMC: 9753143. DOI: 10.1002/mp.15178. View

Arnold B, Thomas D, Rosen J, Salazar M, Blasberg J, Boffa D . Lung Cancer in the Very Young: Treatment and Survival in the National Cancer Data Base. J Thorac Oncol. 2016; 11(7):1121-31. DOI: 10.1016/j.jtho.2016.03.023. View

Butkiewicz D, Krzesniak M, Gdowicz-Klosok A, Giglok M, Marszalek-Zenczak M, Suwinski R . Polymorphisms in Gene Predict Clinical Outcome in Unresectable Non-Small Cell Lung Cancer Treated with Radiotherapy and Platinum-Based Chemoradiotherapy. Int J Mol Sci. 2021; 22(11). PMC: 8197839. DOI: 10.3390/ijms22115605. View

Tsai J, Saad O, Magesh S, Xu J, Lee A, Li W . Tobacco Smoke and Electronic Cigarette Vapor Alter Enhancer RNA Expression That Can Regulate the Pathogenesis of Lung Squamous Cell Carcinoma. Cancers (Basel). 2021; 13(16). PMC: 8391195. DOI: 10.3390/cancers13164225. View

Kujtan L, Muthukumar V, Kennedy K, Davis J, Masood A, Subramanian J . The Role of Systemic Therapy in the Management of Stage I Large Cell Neuroendocrine Carcinoma of the Lung. J Thorac Oncol. 2018; 13(5):707-714. DOI: 10.1016/j.jtho.2018.01.019. View

Son C, Liauw S, Hasan Y, Solanki A . Optimizing the Role of Surgery and Radiation Therapy in Urethral Cancer Based on Histology and Disease Extent. Int J Radiat Oncol Biol Phys. 2018; 102(2):304-313. DOI: 10.1016/j.ijrobp.2018.06.007. View

Trapani D, Giugliano F, Uliano J, Zia V, Marra A, Viale G . Benefit of adjuvant chemotherapy in patients with special histology subtypes of triple-negative breast cancer: a systematic review. Breast Cancer Res Treat. 2021; 187(2):323-337. DOI: 10.1007/s10549-021-06259-8. View

Antonia S, Villegas A, Daniel D, Vicente D, Murakami S, Hui R . Durvalumab after Chemoradiotherapy in Stage III Non-Small-Cell Lung Cancer. N Engl J Med. 2017; 377(20):1919-1929. DOI: 10.1056/NEJMoa1709937. View

10.

Sherman S, Rotem O, Shochat T, Zer A, Moore A, Dudnik E . Efficacy of immune check-point inhibitors (ICPi) in large cell neuroendocrine tumors of lung (LCNEC). Lung Cancer. 2020; 143:40-46. DOI: 10.1016/j.lungcan.2020.03.008. View

11.

Baine M, Verma V, Schonewolf C, Lin C, Simone 2nd C . Histology significantly affects recurrence and survival following SBRT for early stage non-small cell lung cancer. Lung Cancer. 2018; 118:20-26. DOI: 10.1016/j.lungcan.2018.01.021. View

12.

Jiang H, Shao D, Zhao P, Wu Y . The Predictive and Guidance Value of Signet Ring Cell Histology for Stage II/III Colon Cancer Response to Chemotherapy. Front Oncol. 2021; 11:631995. PMC: 7940524. DOI: 10.3389/fonc.2021.631995. View

13.

Kong C, Zhu X, Shi M, Wang L, Chen C, Tao H . Survival and Toxicity of Hypofractionated Intensity Modulated Radiation Therapy in 4 Gy Fractions for Unresectable Stage III Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys. 2020; 107(4):710-719. DOI: 10.1016/j.ijrobp.2020.03.038. View

14.

Wang J, Ye L, Cai H, Jin M . Comparative study of large cell neuroendocrine carcinoma and small cell lung carcinoma in high-grade neuroendocrine tumors of the lung: a large population-based study. J Cancer. 2019; 10(18):4226-4236. PMC: 6691699. DOI: 10.7150/jca.33367. View

15.

Liao W, Chen J, Wu M, Shih J, Chen K, Ho C . Neoadjuvant chemotherapy with docetaxel-cisplatin in patients with stage III N2 non-small-cell lung cancer. Clin Lung Cancer. 2013; 14(4):418-24. DOI: 10.1016/j.cllc.2012.10.003. View

16.

Wang X, Wang Z, Pan J, Lu Z, Xu D, Zhang H . Patterns of Extrathoracic Metastases in Different Histological Types of Lung Cancer. Front Oncol. 2020; 10:715. PMC: 7248315. DOI: 10.3389/fonc.2020.00715. View

17.

Grosu H, Manzanera A, Shivakumar S, Sun S, Noguras Gonzalez G, Ost D . Survival disparities following surgery among patients with different histological types of non-small cell lung cancer. Lung Cancer. 2019; 140:55-58. DOI: 10.1016/j.lungcan.2019.12.007. View

18.

Noronha V, Patil V, Joshi A, Menon N, Chougule A, Mahajan A . Gefitinib Versus Gefitinib Plus Pemetrexed and Carboplatin Chemotherapy in -Mutated Lung Cancer. J Clin Oncol. 2019; 38(2):124-136. DOI: 10.1200/JCO.19.01154. View

19.

Ogawa H, Sakai Y, Nishio W, Fujibayashi Y, Nishikubo M, Nishioka Y . DLL3 expression is a predictive marker of sensitivity to adjuvant chemotherapy for pulmonary LCNEC. Thorac Cancer. 2020; 11(9):2561-2569. PMC: 7471044. DOI: 10.1111/1759-7714.13574. View

20.

Ost D, Goldberg J, Rolnitzky L, Rom W . Survival after surgery in stage IA and IB non-small cell lung cancer. Am J Respir Crit Care Med. 2007; 177(5):516-23. PMC: 2258444. DOI: 10.1164/rccm.200706-815OC. View