Postoperative multidimensional risk factor analysis and nomogram construction in patients with non-small-cell lung cancer

Abstract BackgroundThe aim of this study was to investigate the multidimensional factors affecting overall survival (OS) and progression-free survival (PFS) of patients undergoing non-small-cell lung cancer (NSCLC) resection, and to construct nomograms for visualization based on the consideration of competing risk events.MethodsThis was a prospective, longitudinal cohort study conducted in the Second Affiliated Hospital of Nanchang University from to 2015-2021. We actively collected multidimensional information from 674 patients with NSCLC who underwent surgery in the first three years and were followed up for three years postoperatively. A competitive risk model was used to analyze the factors affecting the prognosis of patients with NSCLC, and a nomogram was developed for individualized evaluation. The effectiveness of the prediction models was measured using the concordance index (C-index), receiver operating characteristic (ROC) curve, and calibration curve.ResultsAge at surgery, number of lymph nodes (LNs) obtained during surgery, T stage, N stage, and prognostic nutritional index (PNI) can predict OS. Addition of adjuvant therapy to this basis can predict PFS. The C-index for the OS nomogram was 0.778 and the AUC was 0.788 (95% CI: 0.667–0.762). The C-index for the PFS nomogram was 0.751 and the AUC was 0.750 (95% CI: 0.681–0.820). The 2-year and 3-year calibration curves also showed good predictive performance.ConclusionsAge at surgery, number of lymph nodes, T stage, N stage, PNI, and adjuvant therapy are relevant in the prognostic evaluation of NSCLC patients undergoing surgery, and the constructed nomograms and competing risk models have good predictive value.