Prognostic Model for Resected Squamous-Cell Lung Cancer

Sara Pilotto, Isabella Sperduti, Giovanni Leuzzi, Marco Chiappetta, Felice Mucilli, Giovanni Battista Ratto, Filippo Lococo, Pierluigi Filosso, Lorenzo Spaggiari, Silvia Novello, Michele Milella, Antonio Santo, Aldo Scarpa, Maurizio Infante, Giampaolo Tortora, Francesco Facciolo, Emilio Bria

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Abstract

INTRODUCTION: We developed one of the first clinicopathological prognostic nomograms for resected squamous cell lung cancer (SQLC). Herein, we validate the model in a larger multicenter cohort and we explore the impact of adjuvant/neoadjuvant treatment (ANT).METHODS: Resected SQLC patients from January 2002 to December 2012 in six institutions were eligible. To each patient was assigned a prognostic score based on those clinicopathological factors included in the model (age, T-descriptor according to TNM 7th edition, lymph nodes, grading). Kaplan-Meier analysis for disease-free/cancer-specific/overall survival (DFS/CSS/OS) was performed according to three-class risk model. Harrell's C-statistics were adopted for model validation. The effect of ANT was adjusted with propensity score (PS).RESULTS: Data from 1,375 patients was gathered (median age: 68 years; male: 86.8%; T-descriptor 1-2/3-4: 71.7%/24.9%; nodes negative/positive: 53.4%/46.6%; grading 1-2/3: 35.0%/41.1%). Data for survival analysis was available for 1,097 patients. With a median follow-up of 55 months, patients at low risk had a significantly longer DFS versus intermediate (HR 1.67, 95% CI 1.40-2.01) and high risk (HR 2.46, 95% CI 1.90-3.19), as well as for CSS (HR 2.46, 95% CI 1.80-3.36; HR 4.30, 95% CI 2.92-6.33) and OS (HR 1.79, 95% CI 1.48-2.17; HR 2.33, 95% CI 1.76-3.07). A trend in favor of ANT was observed for intermediate/high risk patients, particularly for CSS (p=0.06; 5-year CSS 72.7% versus 60.8%).CONCLUSIONS: A model based on a combination of easily available clinicopathological factors effectively stratifies resected SQLC patients in three-risk classes.
Original languageEnglish
JournalJournal of Thoracic Oncology
DOIs
Publication statusPublished - Dec 18 2017

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Pilotto, S., Sperduti, I., Leuzzi, G., Chiappetta, M., Mucilli, F., Ratto, G. B., Lococo, F., Filosso, P., Spaggiari, L., Novello, S., Milella, M., Santo, A., Scarpa, A., Infante, M., Tortora, G., Facciolo, F., & Bria, E. (2017). Prognostic Model for Resected Squamous-Cell Lung Cancer. Journal of Thoracic Oncology. https://doi.org/10.1016/j.jtho.2017.12.003