The incidence, risk factors and predictive nomograms for early death of lung cancer with synchronous brain metastasis: a retrospective study in the SEER database

被引:38
作者
Shen, Heng [1 ,2 ]
Deng, Gang [1 ]
Chen, Qianxue [1 ]
Qian, Jin [2 ]
机构
[1] Wuhan Univ, Renmin Hosp, Dept Neurosurg, 238 Jiefang Rd, Wuhan 430060, Hubei, Peoples R China
[2] Hubei Univ Med, Suizhou Hosp, Dept Neurosurg, 60 Longmen St, Suizhou 441399, Hubei, Peoples R China
关键词
Lung cancer; Brain metastases; Nomogram; Early death; LIFETIME OCCURRENCE; EPIDEMIOLOGY; THERAPY; SURVEILLANCE; DIAGNOSIS; PROGNOSIS;
D O I
10.1186/s12885-021-08490-4
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BackgroundThe prognosis of lung cancer with synchronous brain metastasis (LCBM) is very poor, and patients often die within a short time. However, little is known about the early mortality and related factors in patients with LCBM.MethodsPatients diagnosed with LCBM between 2010 and 2016 were enrolled from the Surveillance, Epidemiology, and End Result (SEER) database. Univariate and multivariate logistic regression analysis were used to identify significant independent prognostic factors, which were used to construct nomograms of overall and cancer-specific early death. Then, the prediction ability of the model was verified by receiver operating characteristic (ROC) curve. At last, the clinical application value of the model was tested through decision curve analysis (DCA).ResultsA total of 29,902 patients with LCBM were enrolled in this study. Among them, 13,275 (44.4%) patients had early death, and 11,425 (38.2%) cases died of lung cancer. The significant independent risk factors for overall and cancer-specific early death included age, race, gender, Gleason grade, histological type, T stage, N stage, bone metastasis, liver metastasis and marital status, which were used to construct the nomogram. The ROC curve demonstrated good predictive ability and clinical application value. The areas under the curve (AUC) of the training group was 0.793 (95% CI: 0.788-0.799) and 0.794 (95% CI: 0.788-0.799), in the model of overall and cancer-specific early death respectively. And the AUC of the validation group were 0.803 (95% CI: 0.788-0.818) and 0.806 (95% CI: 0.791-0.821), respectively. The calibration plots of the model showed that the predicted early death is consistent with the actual value. The DCA analysis indicated a good clinical application value of this model.ConclusionsWe established a comprehensive nomogram to predict early death in lung cancer patients with synchronous brain metastases. Nomograms may help oncologists develop better treatment strategies, such as clinical trials and hospice care.
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页数:17
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