Inventory reference ISSN 1812-7231 Klin.inform.telemed. Volume 10, Issue 11, 2014, Pages 81–88
Author(s) O. P. Kolesnik1, A. I. Shevchenko1, Y. Е. Lyakh2, V. G. Gurianov2
1Zaporozhye state medical university, Ukraine 2The Maxim Gorky Donetsk National medical university, Ukraine
Article title The total scale for prognosis of survival patients with early stages of non-small cell lung cancer
Purpose. The aim of our study was to create a predictive model to identify patients with early-stage NSCLC with poor prognosis.
Materials and methods. The study was conducted in 254 patients with early-stage NSCLC, who were treated between June 2008 and December 2012 at the Department of Thoracic Surgery Zaporozhye Regional Clinical Oncology Center. Based on a complex turn-based statistical methods we established the total point scale prediction of adverse disease course in patients with early-stage NSCLC. The first step in building scale — a list of the variables that are potential predictors we have selected 39 variables.
Result and discussion. Predictors that had a statistical relationship with the dependent variable with the level of significance (p = 0, 1) and fewer were still included in the regression model. As regression model was selected for optimum scaling Regression (Regression with Optimal scaling (CATREG)) (implemented in SPSS 17.0). Thus, taking into account the categorization to the regression model included 12 of the 39 potential predictors: size of tumor (cm), criterion "N", stage of disease, histological form of the tumor, surgery volume, volume of lymphdissection, intrapericardial ligation of vessels, complaint to hemoptysis, Ki-67 expression, expression of Her-2-neu, expression of EGFR, pancytokeratine expression.
The last step of the scale is the practical test adequacy threshold point. It was accounted the actual rate of death from progression of NSCLC patients with a total score of 28 or less. It amounted to 8, 8±2, 7% (about 10%). The actual rate of progress NMKRL deaths in patients with a total score of over 28 was 48, 9±4, 2% (about 50%). Model specificity was 58, 9%, sensitivity — 87, 3%.
Conclusion. The result of our study was to create a scale that is based on estimates of 12 signs of the patient can speak objectively about the risk of death by probability. Patients with prognostic score of more than 28 dynamic requires careful monitoring to detect early recurrence and further treatment.
Keywords Prognostic model, Survival, Non small cell lung cancer
1. Charles L., Soria J.-Ch., Tang X., et al. Prognostic Factors in Resected Stage I Non–Small-Cell Lung Cancer: A Multivariate Analysis of Six Molecular Markers. J. Clin. Oncol., 2004, vol. 22, pp. 4575–4583.
2. Chen D.-T., Ying-Lin Hsu, William J. Fulp et al. Prognostic and Predictive Value of a Malignancy-Risk Gene Signature in Early-Stage Non–Small Cell Lung Cancer. J. Natl. Cancer Inst., 2011, vol. 103, pp. 1859–1870.
3. D'Amato T. A. Adjuvant chemotherapy and the role of chemotherapy resistance testing for stage I non-small cell lung cancer. Thorac Surg. Clin., 2007, vol. 17, pp. 287–299.
4. D'Amico T. A., Massey M., James E. Herndon et al. A biologic risk model for stage i lung cancer: immunohistochemical analysis of 408 patients with the use of ten molecular markers. J. Thorac Cardiovasc. Surg., 1999, vol. 117, pp. 736–743.
5. Dosaka-Akita H., Hommura F., Mishina T., et al. A Risk-Stratification Model of Non-Small Cell Lung Cancers Using Cyclin E, Ki-67, and rasp21: Different Roles of G1 Cyclins in Cell Proliferation and Prognosis. Cancer Res., 2001, vol. 61, pp. 2500–2504.
6. Fedorenko Z. P., Goulak L. O., Gorokh Y. Cancer in Ukraine, 2011–2012. Bulletin of national cancer registry of Ukraine, Kyiv, 2013.
7. Gopal R. S., Komaki R. U., Bradley J. et al. Expert Panel on Radiation Oncology-Lung Work Group. Induction and adjuvant therapy for N2 non-small-cell lung cancer. [online publication]. Reston (VA): American College of Radiology (ACR), 2006, 16 p.
8. Harpole D. H. Prognostic modeling in early stage lung cancer: an evolving process from histopathology to genomics. Thorac Surg Clin., 2007, vol. 17, pp. 167–173.
9. Harpole D. H., Herndon Jr. J. E., Wolfe W. G., et al. A Prognostic Model of Recurrence and Death in Stage I Non-Small Cell Lung Cancer Utilizing Presentation, Histopathology, and Oncoprotein Expression. Cancer Res., 1995, vol. 55, pp. 51–56.
10. Hilbe W., Dirnhofer S., Oberwasserlechner F. et al. Immunohistochemical typing of non-small cell lung cancer on cryostat sections: correlation with clinical parameters and prognosis. J. Clin. Pathol., 2003, vol. 56, pp. 736–741.
11. Holdenrieder S., Nagel D., Heinemann V., et al Predictive and prognostic biomarker models in advanced lungcancer. J. of Clinical Oncology, 2008, vol. 26, 15p., 19010.
12. Konopa K. Do we have markers to select patients for adjuvant therapies of non-small-cell lung cancer? Annals of Oncology, 2010, pp. 199–202.
13. Leonardus L. R. van der Pijl, Özcan Birim, Menno van Gameren et al. Validation of a prognostic model to predict survival after non-small-cell lung cancer surgery. European Journal of Cardio-thoracic Surgery, 2010, vol. 38, pp. 615–620.
14. López-Encuentra A., López-Rios, Conde E., et al. Composite anatomical–clinical–molecular prognostic model in F. nonsmall cell lung cancer. Our. Respir. J., 2011, vol. 37, pp. 136–142.
15. Park S. Y., Lee H.-S., Jang H.-J. et al. Tumor Necrosis as a Prognostic Factor for Stage IA Non-Small Cell Lung Cancer. Ann. Thorac. Surg. 2011, vol. 91, pp. 1668–1673.
16. Raz, D. J. Ray M. R., Kim J. Y., et al. A Multigene Assay Is Prognostic of Survival in Patients with Early-Stage Lung Adenocarcinoma. Clin. Cancer Res. 2008, vol. 14, pp. 5565–5570.
17. Rubio L., Vera-Sempere F. J., Lopez-Guerrero J. A. et al. A Risk Model for Non-small Cell Lung Cancer Using Clinicopathological Variables, Angiogenesis and Oncoprotein Expression. Anticancer research, 2005, vol. 25, pp. 497–504.
18. Smythe W. R. Treatment of stage I non-small cell lung carcinoma. Chest., 2003, vol. 123, pp. 181–187.
19. Williams B. A., Sugimura H., Endo Ch., et al. Predicting Postrecurrence Survival Among Completely Resected Nonsmall-Cell Lung Cancer Patients. Ann Thorac Surg. 2006, vol. 81, pp. 1021–1027.
20. Zeller J. L., Lynm C., Glass R. M. Lung cancer. JAMA, 2007, vol. 297, iss. 9, p. 1.
21. Zhu C-Q, W. Shih, C-H Ling, M-S Tsao. Immunohistochemical markers of prognosis in non-small cell lung cancer: a review and proposal for a multiphase approach to marker evaluation. J. Clin. Pathol., 2006, vol. 59, pp. 790–800.
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