Validation of survival prognostic models for non-small-cell lung cancer in stage- and age-specific groups.

TitleValidation of survival prognostic models for non-small-cell lung cancer in stage- and age-specific groups.
Publication TypeJournal Article
Year of Publication2015
AuthorsWang, Xiaofei, Lin Gu, Ying Zhang, Daniel J. Sargent, William Richards, Apar Kishor Ganti, Jeffery Crawford, Harvey Jay Cohen, Thomas Stinchcombe, Everett Vokes, and Herbert Pang
JournalLung Cancer
Volume90
Issue2
Pagination281-7
Date Published2015 Nov
ISSN1872-8332
KeywordsAged, Carcinoma, Non-Small-Cell Lung, Female, Humans, Lung Neoplasms, Male, Middle Aged, Neoplasm Staging, Prognosis
Abstract

PURPOSE: Prognostic models have been proposed to predict survival for non-small-cell lung cancer (NSCLC). It is important to evaluate whether these models perform better than performance status (PS) alone in stage- and age-specific subgroups.PATIENTS AND METHODS: The validation cohort included 2060 stage I and 1611 stage IV NSCLC patients from 23CALGB studies. For stage I, Blanchon (B), Chansky (C) and Gail (G) models were evaluated along with the PS only model. For stage IV, Blanchon (B) and Mandrekar (M) models were compared with the PS only model. The c-index was used to assess the concordance between survival and risk scores. The c-index difference (c-difference) and the integrated discrimination improvement (IDI) were used to determine the improvement of these models over the PS only model.RESULTS: For stage I, B and PS have better survival separation. The c-index for B, PS, C and G are 0.61, 0.58, 0.57 and 0.52, respectively, and B performs significantly better than PS with c-difference=0.034. For stage IV, B, M and PS have c-index 0.61, 0.64 and 0.60, respectively; B and M perform significantly better than PS with c-difference=0.015 and 0.033, respectively.CONCLUSION: Although some prognostic models have better concordance with survival than the PS only model, the absolute improvement is small. More accurate prognostic models should be developed; the inclusion of tumor genetic variants may improve prognostic models.

DOI10.1016/j.lungcan.2015.08.007
Alternate JournalLung Cancer
Original PublicationValidation of survival prognostic models for non-small-cell lung cancer in stage- and age-specific groups.
PubMed ID26319317
PubMed Central IDPMC4619143
Grant ListU10 CA047577 / CA / NCI NIH HHS / United States
CA33601 / CA / NCI NIH HHS / United States
CA47577 / CA / NCI NIH HHS / United States
5R21AG042894 / AG / NIA NIH HHS / United States
CA41287 / CA / NCI NIH HHS / United States
U10 CA031946 / CA / NCI NIH HHS / United States
U10 CA033601 / CA / NCI NIH HHS / United States
R21 AG042894 / AG / NIA NIH HHS / United States
U10 CA180821 / CA / NCI NIH HHS / United States
U10CA180882 / CA / NCI NIH HHS / United States
U10 CA041287 / CA / NCI NIH HHS / United States
U10 CA047559 / CA / NCI NIH HHS / United States
U10 CA180882 / CA / NCI NIH HHS / United States
CA47559 / CA / NCI NIH HHS / United States
P01 CA142538 / CA / NCI NIH HHS / United States
U10CA180821 / CA / NCI NIH HHS / United States
U10 CA180838 / CA / NCI NIH HHS / United States
CA180821 / CA / NCI NIH HHS / United States
CA31946 / CA / NCI NIH HHS / United States
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