Risk Factor Analysis Of Overall Survival Rate In Patients With Stage Ⅰ Non-small Cell Lung Cancer And Development And Validation Of Nomogram Model

Objective This study aimed to explore the risk factors for overall survival in patients with stage Ⅰ non-small cell lung cancer(NSCLC)undergoing surgical treatment,and to construct and verify the prognostic nomogram of patients with stage I non-small cell lung cancer.Methods A total of 482 patients with stage I NSCLC who underwent radical surgery in zhejiang taizhou hospital between October 2010 and December 2015 were included.All patients were divided into training cohort(n=338)and validation cohort(n=144)randomly.The clinical,pathological and laboratory indexes determined before surgery were selected,Cox regression analysis was performed to determine the influencing factors affecting the overall survival of patients with stage I NSCLC of training cohort,and a nomogram model was established.Receiver Operating Characteristic(ROC)curve and C index were calculated to evaluate the predictive ability of the model,and the accuracy of the model was evaluated by the calibration curve.Subsequently,the decision curve analysis(DCA)was compared with the tumor-node-metastasis(TNM)staging system to verify the clinical utility of the nomogram.The dangerous layering of the model was carried out through the X-tile software.Results The median survival time of 482 patients with stage I NSCLC was 101(range 90-115)months.A total of 112 deaths,with an overall mortality rate of 23.2%.Cox analysis showed that the independent risk factors for overall survival in stage I NSCLC patients were age,grade and tumor diameter,and a nomogram model was constructed.The C indices of training cohort and validation cohort were 0.781(95%CI,0.734-0.827)and 0.827(95%CI,0.769-0.885),respectively.The area under the ROC curve(AUC)was 0.805 for the training cohort and 0.835 for the validation cohort.Patients were divided into two groups by X-tile software:the low-risk group(<132.6,n=)and the high-risk group(≥132.6,n=).The survival rate of patients in the low-risk group was significantly higher than that in the high-risk group(logrank,p<0.001).Conclusion In this study,a nomogram model for postoperative survival of patients with stageⅠ NSCLC was developed and validated,and the risk stratification of patients was performed by nomogram model.With this model,clinicians can better identify patients with poor prognosis and assist them in providing more personalized treatment decisions.