Lung cancer prognostic index: a risk score to predict overall survival after the diagnosis of non-small-cell lung cancer
AuthorAlexander, M; Wolfe, R; Ball, D; Conron, M; Stirling, RG; Solomon, B; MacManus, M; Officer, A; Karnam, S; Burbury, K; ...
Source TitleBritish Journal of Cancer
PublisherNATURE PUBLISHING GROUP
University of Melbourne Author/sConron, Matthew; Ball, David; Solomon, Benjamin; MacManus, Michael; Alexander, Marliese
AffiliationMedicine and Radiology
Sir Peter MacCallum Department of Oncology
Document TypeJournal Article
CitationsAlexander, M., Wolfe, R., Ball, D., Conron, M., Stirling, R. G., Solomon, B., MacManus, M., Officer, A., Karnam, S., Burbury, K. & Evans, S. M. (2017). Lung cancer prognostic index: a risk score to predict overall survival after the diagnosis of non-small-cell lung cancer. BRITISH JOURNAL OF CANCER, 117 (5), pp.744-751. https://doi.org/10.1038/bjc.2017.232.
Access StatusOpen Access
INTRODUCTION: Non-small-cell lung cancer outcomes are poor but heterogeneous, even within stage groups. To improve prognostic precision we aimed to develop and validate a simple prognostic model using patient and disease variables. METHODS: Prospective registry and study data were analysed using Cox proportional hazards regression to derive a prognostic model (hospital 1, n=695), which was subsequently tested (Harrell's c-statistic for discrimination and Cox-Snell residuals for calibration) in two independent validation cohorts (hospital 2, n=479 and hospital 3, n=284). RESULTS: The derived Lung Cancer Prognostic Index (LCPI) included stage, histology, mutation status, performance status, weight loss, smoking history, respiratory comorbidity, sex, and age. Two-year overall survival rates according to LCPI in the derivation and two validation cohorts, respectively, were 84, 77, and 68% (LCPI 1: score⩽9); 61, 61, and 42% (LCPI 2: score 10-13); 33, 32, and 14% (LCPI 3: score 14-16); 7, 16, and 5% (LCPI 4: score ⩾15). Discrimination (c-statistic) was 0.74 for the derivation cohort, 0.72 and 0.71 for the two validation cohorts. CONCLUSIONS: The LCPI contributes additional prognostic information, which may be used to counsel patients, guide trial eligibility or design, or standardise mortality risk for epidemiological analyses.
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