Analysis of clinical features and prognostic risk factors in elderly lung adenocarcinoma patients
10.3760/cma.j.issn.0254-9026.2024.11.005
- VernacularTitle:老年肺腺癌患者的临床特征及预后危险因素分析
- Author:
Shuang ZHAO
1
;
Han YANG
;
Haijuan ZHAO
;
Miao MIAO
;
Qingqing WANG
;
Yaru WANG
;
Yuying YIN
;
Huiqing YAO
;
Fei LIU
;
Xin WANG
Author Information
1. 北京医院临床试验研究中心 国家老年医学中心 中国医学科学院老年医学研究院，北京 100730
- Keywords:
Lung neoplasms;
Adenocarcinoma;
Nomograms;
Prognosis
- From:
Chinese Journal of Geriatrics
2024;43(11):1402-1408
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aims to analyze the clinical characteristics of elderly patients with lung adenocarcinoma and to construct a predictive model for assessing their survival.Methods:We conducted a retrospective analysis of clinical data sourced from the SEER database for patients aged 60 years or older who were diagnosed with lung adenocarcinoma between 2013 and 2018.Cox regression analysis was employed to identify independent prognostic factors affecting the survival of elderly lung adenocarcinoma patients, leading to the development of a nomogram model.The discriminative ability and calibration of the nomogram were assessed using the C-index and calibration curve.Each patient's total risk score was calculated based on the predictive model, and patients were stratified according to the quartiles of their total risk scores.The Kaplan-Meier method and Log-rank test were utilized to evaluate survival differences among the identified risk groups.Results:Among 38, 852 lung adenocarcinoma patients, 17, 200 were males and 21, 652 were females.Significant differences in survival rates were observed among lung adenocarcinoma patients based on age, gender, marital status, histological grade, TNM stage, tumor size, and the presence of bone, brain, or liver metastases, as well as the type of treatment received, including surgical treatment, radiation therapy, and chemotherapy(all P<0.001).The C-index of the training model was 0.815(95% CI: 0.811-0.819), while the validation model yielded a C-index of 0.810(95% CI: 0.804-0.816).The prediction model demonstrated higher Area Under Curve(AUC)values of 0.746, 0.768, and 0.775 for 1-year, 3-year, and 5-year survival in the modeling dataset, respectively, and 0.747, 0.770, and 0.777 in the validation dataset.Furthermore, the risk stratification model effectively distinguished patients at varying levels of risk( P<0.001). Conclusions:Age, gender, marital status, histological grade, TNM stage, tumor size, and the presence of bone, brain, and liver metastases, along with treatment modalities such as surgery, radiotherapy, and chemotherapy, were identified as independent prognostic factors for elderly patients with lung adenocarcinoma.The risk prediction model developed in this study effectively differentiates between patients at varying levels of risk, which holds significant implications for predicting treatment responses in elderly lung adenocarcinoma patients and advancing the practice of precision medicine.
