Prognostic evaluation of stage I lung adenocarcinoma based on systematic inflammatory response
Menée en Chine à partir de données portant sur 913 patients atteints d'un adénocarcinome du poumon de stade I avec mutation EGFR, cette étude évalue la performance d'un nomogramme, incluant les rapports neutrophiles-lymphocytes et plaquettes-lymphocytes, pour prédire la survie des patients
Background : This study aimed to construct an effective nomogram based on the clinical and laboratory characteristics to predict the prognosis of stage I lung adenocarcinoma (LUAD) with epidermal growth factor receptor (EGFR) mutation.
Methods : A retrospective study was performed on 913 eligible patients with EGFR mutation after surgery at Shanghai Pulmonary Hospital. The peripheral blood indicators were included in the nomogram. Calibration plots, concordance index (C-index), decision curve analysis (DCA), and the X-tile software were used in this study. Recurrence-free survival (RFS) and overall survival (OS) were estimated by the Kaplan-Meier method and compared by using the log-rank test.
Results : Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were independent risk factors for RFS. The calibration curves for RFS probabilities showed a good agreement between the nomogram prediction and actual observation. Furthermore, the nomogram including NLR and PLR had a higher C-index (0.732, 95% CI, 0.706-0.758) than that without NLR or PLR (0.713, 95% CI, 0.686-0.740), and DCA plots showed that the nomogram with NLR and PLR had better clinical practicability. Additionally, the patients were divided into two groups according to cut-off values of risk points, and significant differences in RFS and OS were observed between the high-risk and low-risk groups (P < 0.001).
Conclusions : High pretreatment levels of NLR and PLR were strongly associated with a worse prognosis in stage I EGFR-mutated LUADs. Besides, the proposed nomogram with NLR and PLR presented a better prediction ability for the survival of those patients.
JNCI Cancer Spectrum , article en libre accès, 2022