Prognostic Model for Resected Squamous Cell Lung Cancer: External Multicenter Validation and Propensity Score Analysis exploring the Impact of Adjuvant and Neoadjuvant Treatment

S. Pilotto, I. Sperduti, G. Leuzzi, M. Chiappetta, F. Mucilli, G. B. Ratto, F. Lococo, P. L. Filosso, L. Spaggiari, S. Novello, M. Milella, A. Santo, A. Scarpa, M. Infante, G. Tortora, F. Facciolo, E. Bria

Research output: Contribution to journalArticle

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 and neoadjuvant treatment (ANT). METHODS: Patients with resected SQLC from January 2002 to December 2012 in six institutions were eligible. Each patient was assigned a prognostic score based on the clinicopathological factors included in the model (age, T descriptor according to seventh edition of the TNM classification, lymph node status, and grading). Kaplan-Meier analysis for disease-free survival, cancer-specific survival (CSS), and overall survival was performed according to a three-class risk model. Harrell's C-statistics were adopted for model validation. The effect of ANT was adjusted with propensity score. RESULTS: Data on 1375 patients were gathered (median age, 68 years; male sex, 86.8%; T descriptor 1 or 2 versus 3 or 4, 71.7% versus 24.9%; nodes negative versus positive, 53.4% versus 46.6%; and grading of 1 or 2 versus 3, 35.0% versus 41.1%). Data for survival analysis were available for 1097 patients. With a median follow-up of 55 months, patients at low risk had a significantly longer disease-free survival than did patients at intermediate risk (hazard ratio [HR] = 1.67, 95% confidence interval [CI]: 1.40-2.01) and patients at high risk (HR = 2.46, 95% CI: 1.90-3.19); they also had a significantly longer CSS (HR = 2.46, 95% CI: 1.80-3.36 versus HR = 4.30, 95% CI: 2.92-6.33) and overall survival (HR = 1.79, 95% CI: 1.48-2.17 versus HR = 2.33, 95% CI: 1.76-3.07). A trend in favor of ANT was observed for intermediate-risk/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 patients with resected SQLC into three risk classes.
Original languageEnglish
JournalJournal of Thoracic Oncology
DOIs
Publication statusIn preparation - 2018

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Squamous Cell Neoplasms
Propensity Score
Neoadjuvant Therapy
Lung Neoplasms
Confidence Intervals
Survival
Disease-Free Survival
Neoplasms
Odds Ratio
Nomograms
Neoplasm Staging
Kaplan-Meier Estimate
Survival Analysis
Lymph Nodes

Keywords

  • Adjuvant/neoadjuvant treatment
  • Clinicopathological factors
  • Nomogram
  • Prognosis
  • Squamous lung cancer

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Prognostic Model for Resected Squamous Cell Lung Cancer: External Multicenter Validation and Propensity Score Analysis exploring the Impact of Adjuvant and Neoadjuvant Treatment. / Pilotto, S.; Sperduti, I.; Leuzzi, G.; Chiappetta, M.; Mucilli, F.; Ratto, G. B.; Lococo, F.; Filosso, P. L.; Spaggiari, L.; Novello, S.; Milella, M.; Santo, A.; Scarpa, A.; Infante, M.; Tortora, G.; Facciolo, F.; Bria, E.

In: Journal of Thoracic Oncology, 2018.

Research output: Contribution to journalArticle

Pilotto, S, Sperduti, I, Leuzzi, G, Chiappetta, M, Mucilli, F, Ratto, GB, Lococo, F, Filosso, PL, Spaggiari, L, Novello, S, Milella, M, Santo, A, Scarpa, A, Infante, M, Tortora, G, Facciolo, F & Bria, E 2018, 'Prognostic Model for Resected Squamous Cell Lung Cancer: External Multicenter Validation and Propensity Score Analysis exploring the Impact of Adjuvant and Neoadjuvant Treatment', Journal of Thoracic Oncology. https://doi.org/S1556-0864(17)33101-5 [pii]
Pilotto, S. ; Sperduti, I. ; Leuzzi, G. ; Chiappetta, M. ; Mucilli, F. ; Ratto, G. B. ; Lococo, F. ; Filosso, P. L. ; Spaggiari, L. ; Novello, S. ; Milella, M. ; Santo, A. ; Scarpa, A. ; Infante, M. ; Tortora, G. ; Facciolo, F. ; Bria, E. / Prognostic Model for Resected Squamous Cell Lung Cancer: External Multicenter Validation and Propensity Score Analysis exploring the Impact of Adjuvant and Neoadjuvant Treatment. In: Journal of Thoracic Oncology. 2018.
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title = "Prognostic Model for Resected Squamous Cell Lung Cancer: External Multicenter Validation and Propensity Score Analysis exploring the Impact of Adjuvant and Neoadjuvant Treatment",
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 and neoadjuvant treatment (ANT). METHODS: Patients with resected SQLC from January 2002 to December 2012 in six institutions were eligible. Each patient was assigned a prognostic score based on the clinicopathological factors included in the model (age, T descriptor according to seventh edition of the TNM classification, lymph node status, and grading). Kaplan-Meier analysis for disease-free survival, cancer-specific survival (CSS), and overall survival was performed according to a three-class risk model. Harrell's C-statistics were adopted for model validation. The effect of ANT was adjusted with propensity score. RESULTS: Data on 1375 patients were gathered (median age, 68 years; male sex, 86.8{\%}; T descriptor 1 or 2 versus 3 or 4, 71.7{\%} versus 24.9{\%}; nodes negative versus positive, 53.4{\%} versus 46.6{\%}; and grading of 1 or 2 versus 3, 35.0{\%} versus 41.1{\%}). Data for survival analysis were available for 1097 patients. With a median follow-up of 55 months, patients at low risk had a significantly longer disease-free survival than did patients at intermediate risk (hazard ratio [HR] = 1.67, 95{\%} confidence interval [CI]: 1.40-2.01) and patients at high risk (HR = 2.46, 95{\%} CI: 1.90-3.19); they also had a significantly longer CSS (HR = 2.46, 95{\%} CI: 1.80-3.36 versus HR = 4.30, 95{\%} CI: 2.92-6.33) and overall survival (HR = 1.79, 95{\%} CI: 1.48-2.17 versus HR = 2.33, 95{\%} CI: 1.76-3.07). A trend in favor of ANT was observed for intermediate-risk/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 patients with resected SQLC into three risk classes.",
keywords = "Adjuvant/neoadjuvant treatment, Clinicopathological factors, Nomogram, Prognosis, Squamous lung cancer",
author = "S. Pilotto and I. Sperduti and G. Leuzzi and M. Chiappetta and F. Mucilli and Ratto, {G. B.} and F. Lococo and Filosso, {P. L.} and L. Spaggiari and S. Novello and M. Milella and A. Santo and A. Scarpa and M. Infante and G. Tortora and F. Facciolo and E. Bria",
note = "LR: 20180203; CI: Copyright (c) 2017; JID: 101274235; OTO: NOTNLM; 2017/08/23 00:00 [received]; 2017/12/02 00:00 [revised]; 2017/12/09 00:00 [accepted]; 2017/12/23 06:00 [pubmed]; 2017/12/23 06:00 [medline]; 2017/12/23 06:00 [entrez]; aheadofprint",
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doi = "S1556-0864(17)33101-5 [pii]",
language = "English",
journal = "Journal of Thoracic Oncology",
issn = "1556-0864",
publisher = "Elsevier Inc.",

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TY - JOUR

T1 - Prognostic Model for Resected Squamous Cell Lung Cancer: External Multicenter Validation and Propensity Score Analysis exploring the Impact of Adjuvant and Neoadjuvant Treatment

AU - Pilotto, S.

AU - Sperduti, I.

AU - Leuzzi, G.

AU - Chiappetta, M.

AU - Mucilli, F.

AU - Ratto, G. B.

AU - Lococo, F.

AU - Filosso, P. L.

AU - Spaggiari, L.

AU - Novello, S.

AU - Milella, M.

AU - Santo, A.

AU - Scarpa, A.

AU - Infante, M.

AU - Tortora, G.

AU - Facciolo, F.

AU - Bria, E.

N1 - LR: 20180203; CI: Copyright (c) 2017; JID: 101274235; OTO: NOTNLM; 2017/08/23 00:00 [received]; 2017/12/02 00:00 [revised]; 2017/12/09 00:00 [accepted]; 2017/12/23 06:00 [pubmed]; 2017/12/23 06:00 [medline]; 2017/12/23 06:00 [entrez]; aheadofprint

PY - 2018

Y1 - 2018

N2 - 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 and neoadjuvant treatment (ANT). METHODS: Patients with resected SQLC from January 2002 to December 2012 in six institutions were eligible. Each patient was assigned a prognostic score based on the clinicopathological factors included in the model (age, T descriptor according to seventh edition of the TNM classification, lymph node status, and grading). Kaplan-Meier analysis for disease-free survival, cancer-specific survival (CSS), and overall survival was performed according to a three-class risk model. Harrell's C-statistics were adopted for model validation. The effect of ANT was adjusted with propensity score. RESULTS: Data on 1375 patients were gathered (median age, 68 years; male sex, 86.8%; T descriptor 1 or 2 versus 3 or 4, 71.7% versus 24.9%; nodes negative versus positive, 53.4% versus 46.6%; and grading of 1 or 2 versus 3, 35.0% versus 41.1%). Data for survival analysis were available for 1097 patients. With a median follow-up of 55 months, patients at low risk had a significantly longer disease-free survival than did patients at intermediate risk (hazard ratio [HR] = 1.67, 95% confidence interval [CI]: 1.40-2.01) and patients at high risk (HR = 2.46, 95% CI: 1.90-3.19); they also had a significantly longer CSS (HR = 2.46, 95% CI: 1.80-3.36 versus HR = 4.30, 95% CI: 2.92-6.33) and overall survival (HR = 1.79, 95% CI: 1.48-2.17 versus HR = 2.33, 95% CI: 1.76-3.07). A trend in favor of ANT was observed for intermediate-risk/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 patients with resected SQLC into three risk classes.

AB - 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 and neoadjuvant treatment (ANT). METHODS: Patients with resected SQLC from January 2002 to December 2012 in six institutions were eligible. Each patient was assigned a prognostic score based on the clinicopathological factors included in the model (age, T descriptor according to seventh edition of the TNM classification, lymph node status, and grading). Kaplan-Meier analysis for disease-free survival, cancer-specific survival (CSS), and overall survival was performed according to a three-class risk model. Harrell's C-statistics were adopted for model validation. The effect of ANT was adjusted with propensity score. RESULTS: Data on 1375 patients were gathered (median age, 68 years; male sex, 86.8%; T descriptor 1 or 2 versus 3 or 4, 71.7% versus 24.9%; nodes negative versus positive, 53.4% versus 46.6%; and grading of 1 or 2 versus 3, 35.0% versus 41.1%). Data for survival analysis were available for 1097 patients. With a median follow-up of 55 months, patients at low risk had a significantly longer disease-free survival than did patients at intermediate risk (hazard ratio [HR] = 1.67, 95% confidence interval [CI]: 1.40-2.01) and patients at high risk (HR = 2.46, 95% CI: 1.90-3.19); they also had a significantly longer CSS (HR = 2.46, 95% CI: 1.80-3.36 versus HR = 4.30, 95% CI: 2.92-6.33) and overall survival (HR = 1.79, 95% CI: 1.48-2.17 versus HR = 2.33, 95% CI: 1.76-3.07). A trend in favor of ANT was observed for intermediate-risk/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 patients with resected SQLC into three risk classes.

KW - Adjuvant/neoadjuvant treatment

KW - Clinicopathological factors

KW - Nomogram

KW - Prognosis

KW - Squamous lung cancer

U2 - S1556-0864(17)33101-5 [pii]

DO - S1556-0864(17)33101-5 [pii]

M3 - Article

JO - Journal of Thoracic Oncology

JF - Journal of Thoracic Oncology

SN - 1556-0864

ER -