Establishment of an Adjusted Prognosis Analysis Model for Initially Diagnosed Non–Small-Cell Lung Cancer With Brain Metastases From Sun Yat-Sen University Cancer Center
| Autor: | Qing Liu, De lan Li, Shu Xiang Ma, Yin Duo Zeng, Xiao Xiao Dinglin, Xin ru Chen, Jian Zhong Liang, Li Kun Chen, Fang Wang |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Risk Pulmonary and Respiratory Medicine Oncology China Cancer Research medicine.medical_specialty Prognostic variable Lung Neoplasms Genotype medicine.medical_treatment education Cancer Care Facilities Cohort Studies 03 medical and health sciences 0302 clinical medicine Carcinoma Non-Small-Cell Lung Internal medicine medicine Humans 030212 general & internal medicine Epidermal growth factor receptor Lung cancer Protein Kinase Inhibitors Survival analysis Academic Medical Centers Chemotherapy Models Statistical biology Brain Neoplasms business.industry Hazard ratio Cancer Middle Aged Prognosis medicine.disease Survival Analysis Surgery ErbB Receptors 030220 oncology & carcinogenesis biology.protein Female business |
| Zdroj: | Clinical Lung Cancer. 18:e179-e186 |
| ISSN: | 1525-7304 |
| Popis: | Background The current published prognosis models for brain metastases (BMs) from cancer have not addressed the issue of either newly diagnosed non–small-cell lung cancer (NSCLC) with BMs or the lung cancer genotype. We sought to build an adjusted prognosis analysis (APA) model, a new prognosis model specifically for NSCLC patients with BMs at the initial diagnosis using adjusted prognosis analysis (APA). Patients and Methods The model was derived using data from 1158 consecutive patients, with 837 in the derivation cohort and 321 in the validation cohort. The patients had initially received a diagnosis of BMs from NSCLC at Sun Yat-Sen University Cancer Center from 1994 to 2015. The prognostic factors analyzed included patient characteristics, disease characteristics, and treatments. The APA model was built according to the numerical score derived from the hazard ratio of each independent prognostic variable. The predictive accuracy of the APA model was determined using a concordance index and was compared with current prognosis models. The results were validated using bootstrap resampling and a validation cohort. Results We established 2 prognostic models (APA 1 and 2) for the whole group of patients and for those with known epidermal growth factor receptor (EGFR) genotype, respectively. Six factors were independently associated with survival time: Karnofsky performance status, age, smoking history (replaced by EGFR mutation in APA 2), local treatment of intracranial metastases, EGFR-tyrosine kinase inhibitor treatment, and chemotherapy. Patients in the derivation cohort were stratified into low- (score, 0-2), moderate- (score, 3-5), and high-risk (score 6-7) groups according to the median survival time (16.6, 10.3, and 5.2 months, respectively; P Conclusion Compared with recursive partition analysis and graded prognostic assessment, APA seems to be more suitable for initially diagnosed NSCLC with BMs. |
| Databáze: | OpenAIRE |
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