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ORIGINAL RESEARCH article

Front. Med.
Sec. Pulmonary Medicine
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1491337
This article is part of the Research Topic Advances in the Management of Lung Cancer: From the Bench to the Bedside and Back View all 8 articles

Dynamic assessment of long-term survival in survivors with stage III non-small cell lung Cancer: a novel conditional survival model with a web-based calculator

Provisionally accepted
Xiangdi Meng Xiangdi Meng 1,2Peihe Wang Peihe Wang 1Jie Liu Jie Liu 1Daqing Sun Daqing Sun 1Zhuojun Ju Zhuojun Ju 2Yuanyuan Cai Yuanyuan Cai 1*
  • 1 Weifang People's Hospital, Weifang, China
  • 2 Gunma University Hospital, Maebashi, Gunma, Japan

The final, formatted version of the article will be published soon.

    Background: Conditional survival (CS) analysis can estimate further survival probabilities based on the time already survived, providing dynamic updates for prognostic information. This study aimed to develop a CS-nomogram to promote individualized disease management for stage III non-small cell lung cancer (NSCLC). Methods: This study included patients diagnosed with stage III NSCLC in the Surveillance, Epidemiology, and End Results database from 2010 to 2017 (N =3,512). The CS was calculated as CS(y|x) =OS(y+x)/OS(x), where OS(y+x) and OS(x) were the overall survival (OS) in the year (y+x) and year x, respectively, calculated by the Kaplan-Meier method. We used the least absolute shrinkage and selection operator (LASSO) regression to identify predictors and developed the CS-nomogram based on these predictors and the CS formula. Results: The CS analysis provided real-time updates on survival, with 5-year OS improving dynamically from 14.4% to 29.9%, 47.9%, 66.0%, and 80.8% (after 1–4 years of survival). Six independent predictors (age, tumor size, N status, surgery, radiotherapy and chemotherapy) were identified for the development of the CS-nomogram and its web version (https://dynapp.shinyapps.io/NSCLC/). The model performed with an excellent concordance index (C-index) of 0.71 (95% CI: 0.70–0.72), and a median time-dependent AUC of 0.71–0.73 from 200 iterations 5-fold cross-validation. Conclusions: The study demonstrated the improvement in real-time OS over time in stage III NSCLC survivors and developed the novel CS-nomogram to provide patients with updated survival data. It provided novel insights into clinical decisions in follow-up and treatment for survivors, offering a convenient tool for optimize resource allocation.

    Keywords: Conditional survival, Non-small cell lung cancer, nomogram, overall survival, Prognostic factor

    Received: 04 Sep 2024; Accepted: 16 Dec 2024.

    Copyright: © 2024 Meng, Wang, Liu, Sun, Ju and Cai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yuanyuan Cai, Weifang People's Hospital, Weifang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.