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Zhang Y, Wan W, Shen R, Zhang B, Wang L, Zhang H, Ren X, Cui J, Liu J. Prognostic Factors and Construction of Nomogram Prediction Model of Lung Cancer Patients Using Clinical and Blood Laboratory Parameters. Onco Targets Ther 2024; 17:131-144. [PMID: 38405176 PMCID: PMC10894599 DOI: 10.2147/ott.s444396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/31/2024] [Indexed: 02/27/2024] Open
Abstract
Objective This work aimed to explore the prognostic risk factors of lung cancer (LC) patients and establish a line chart prediction model. Methods A total of 322 LC patients were taken as the study subjects. They were randomly divided into a training set (n = 202) and a validation set (n = 120). Basic information and laboratory indicators were collected, and the progression-free survival (PFS) and overall survival (OS) were followed up. Single-factor and cyclooxygenase (COX) multivariate analyses were performed on the training set to construct a Nomogram prediction model, which was validated with 120 patients in the validation set, and Harrell's consistency was analyzed. Results Single-factor analysis revealed significant differences in PFS (P<0.05) between genders, body mass index (BMI), carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), squamous cell carcinoma antigen (SCCA), treatment methods, treatment response evaluation, smoking status, presence of pericardial effusion, and programmed death ligand 1 (PD-L1) at 0 and 1-50%. Significant differences in OS (P<0.05) were observed for age, tumor location, treatment methods, White blood cells (WBC), uric acid (UA), CA125, pro-gastrin-releasing peptide (ProGRP), SCCA, cytokeratin fragment 21 (CYFRA21), and smoking status. COX analysis identified male gender, progressive disease (PD) as treatment response, and SCCA > 1.6 as risk factors for LC PFS. The consistency indices of the line chart models for predicting PFS and OS were 0.782 and 0.772, respectively. Conclusion Male gender, treatment response of PD, and SCCA > 1.6 are independent risk factors affecting the survival of LC patients. The PFS line chart model demonstrates good concordance.
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Affiliation(s)
- Yamin Zhang
- Department of Oncology, Xi’an International Medical Center Hospital, Xi’an, Shaanxi, 710100, People’s Republic of China
| | - Wei Wan
- Department of Oncology, Xi’an International Medical Center Hospital, Xi’an, Shaanxi, 710100, People’s Republic of China
| | - Rui Shen
- Department of Oncology, Xi’an International Medical Center Hospital, Xi’an, Shaanxi, 710100, People’s Republic of China
| | - Bohao Zhang
- Department of Oncology, Xi’an International Medical Center Hospital, Xi’an, Shaanxi, 710100, People’s Republic of China
| | - Li Wang
- Department of Oncology, Xi’an International Medical Center Hospital, Xi’an, Shaanxi, 710100, People’s Republic of China
| | - Hongyi Zhang
- Department of Urology, The First Affiliated Hospital of Xi’an Medical University, Xi’an, Shaanxi, 710077, People’s Republic of China
| | - Xiaoyue Ren
- College of Life Sciences, Northwest University, Xi’an, Shaanxi, 710069, People’s Republic of China
| | - Jie Cui
- Department of Oncology, The First Affiliated Hospital of Xi’an Medical University, Xi’an, Shaanxi, 710077, People’s Republic of China
| | - Jinpeng Liu
- Department of Oncology, Xi’an International Medical Center Hospital, Xi’an, Shaanxi, 710100, People’s Republic of China
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Qiu H, Lou Y, Wang Z, Xue F, Chen Z, Xu C, Witharana P, Chen D, Zhu K, Li J, Chen B, Fumimoto S, Lachkar S, Efird JT, Zhu C, Shen J. Factors influencing surgical choice and anxiety in patients with pulmonary nodules smaller than 8 mm. J Thorac Dis 2023; 15:6889-6897. [PMID: 38249895 PMCID: PMC10797356 DOI: 10.21037/jtd-23-1701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 12/13/2023] [Indexed: 01/23/2024]
Abstract
Background The detection of pulmonary nodules significantly impacts the lives and mental health of patients. Although the 2020 National Comprehensive Cancer Network (NCCN) guidelines recommend scheduled surveillance for nodules ≤8 mm, patients often opt to have their nodules surgically removed. Methods A cross-sectional questionnaire was administered to patients with small pulmonary nodules who presented to a local grade 3 hospital with small pulmonary nodules and decided to receive surgery versus prescribed monitoring. The questionnaire included four aspects: (I) patient characteristics; (II) nodule-specific knowledge; (III) doctor-patient communication; and (IV) nodular-specific distress. Nodular-specific distress was measured by the Impact of Event Scale-Revised (IES-R). Results A total of 234 (69%) patients responded to the survey and were included in the final analysis. Poor performance in activities of daily living (ADLs), the presence of solid nodules, multifocal disease, and a family history of lung cancer were significantly associated with reported anxiety. Most notably, facilitating patient choice for surgery was the computed tomography (CT) scan results, with reference to lung nodule size and number of nodules, where concerns related to lung nodule, cancer risk, and fear of surgery or death had a significant psychological impact on patients. Conclusions In this cohort of patients who elected to have their small pulmonary nodules surgically removed, we identified key factors underlying their anxiety toward guideline recommended surveillance. Our findings will be useful for clinicians when discussing treatment options with their patients.
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Affiliation(s)
- Hongbin Qiu
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Yingqiao Lou
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Zimin Wang
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Fenglai Xue
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Zhongxiao Chen
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Congcong Xu
- Department of Cardiothoracic Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou University, Taizhou, China
| | - Pasan Witharana
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Dong Chen
- Department of Thoracic Surgery, Jinhua Hospital of Zhejiang University, Jinhua, China
| | - Kanghao Zhu
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Jiawei Li
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Baofu Chen
- Department of Cardiothoracic Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou University, Taizhou, China
| | - Satoshi Fumimoto
- Department of Thoracic and Cardiovascular Surgery, Osaka Medical College, Osaka, Japan
| | - Samy Lachkar
- Department of Pneumology, CHU Rouen, Rouen, France
| | - Jimmy T. Efird
- VA Cooperative Studies Program Coordinating Center, Boston, MA, USA
- Department of Radiation Oncology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Chengchu Zhu
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Jianfei Shen
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
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