Combining COPD with clinical, pathological and demographic information refines prognosis and treatment response prediction of non-small cell lung cancer.
Combining COPD with clinical, pathological and demographic information refines prognosis and treatment response prediction of non-small cell lung cancer.
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DOI：
10.1371/journal.pone.0100994
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Guo NL
中科院分区：
文献类型：
--
作者：
Putila J;Guo NL
准确评估患者的复发风险和治疗反应是肺癌个体化治疗的重要前提。这项研究扩展了之前描述的非小细胞肺癌预后模型，通过使用关联的SEER-Medicare数据增加了化疗和合并症。应用34,203例肺腺癌和26,967例肺鳞癌患者的资料，在30种治疗组合中，确定慢性阻塞性肺疾病(COPD)对预后的贡献。包括COPD的COX模型在1000个自举样本上被评估，结果模型根据ROC、Brier评分、Harrell‘s C和Nagelkerke’s R2指标进行评估，以评估与没有COPD的模型相比在预测方面的改善。在多组患者中，COPD被添加到包含癌症分期、年龄、性别、种族和肿瘤分级的模型中被显示为改善预后。对于肺腺癌患者，总体患者和未接受化疗的患者(包括仅接受手术的患者)的预后都有所改善。对于鳞状细胞癌，在总体患者群体和接受多种类型化疗的患者中都可以看到预后的改善。COPD的病情能够将接受相同治疗的患者分成显著不同的预后组(对数等级p<；0.05)，与癌症分期无关。结合COPD、癌症分期、年龄、性别、种族和肿瘤分级的患者信息可以改善个体非小细胞肺癌患者的预后和治疗反应的预测。该模型能够对综合治疗方案的预后和临床结果进行精确的估计，为个性化的临床决策提供了有用的工具。
Accurate assessment of a patient’s risk of recurrence and treatment response is an important prerequisite of personalized therapy in lung cancer. This study extends a previously described non-small cell lung cancer prognostic model by the addition of chemotherapy and co-morbidities through the use of linked SEER-Medicare data. Data on 34,203 lung adenocarcinoma and 26,967 squamous cell lung carcinoma patients were used to determine the contribution of Chronic Obstructive Pulmonary Disease (COPD) to prognostication in 30 treatment combinations. A Cox model including COPD was estimated on 1,000 bootstrap samples, with the resulting model assessed on ROC, Brier Score, Harrell’s C, and Nagelkerke’s R2 metrics in order to evaluate improvements in prognostication over a model without COPD. The addition of COPD to the model incorporating cancer stage, age, gender, race, and tumor grade was shown to improve prognostication in multiple patient groups. For lung adenocarcinoma patients, there was an improvement on the prognostication in the overall patient population and in patients without receiving chemotherapy, including those receiving surgery only. For squamous cell carcinoma, an improvement on prognostication was seen in both the overall patient population and in patients receiving multiple types of chemotherapy. COPD condition was able to stratify patients receiving the same treatments into significantly (log-rank p<0.05) different prognostic groups, independent of cancer stage. Combining patient information on COPD, cancer stage, age, gender, race, and tumor grade could improve prognostication and prediction of treatment response in individual non-small cell lung cancer patients. This model enables refined prognosis and estimation of clinical outcome of comprehensive treatment regimens, providing a useful tool for personalized clinical decision-making.
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预测切除非鳞状非小细胞肺癌生存率的实用分子测定：开发和国际验证研究
影响因子：
168.9
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Kratz, Johannes R.;He, Jianxing;Van den Eeden, Stephen K.;Zhu, Zhi-Hua;Gao, Wen;Pham, Patrick T.;Mulvihill, Michael S.;Ziaei, Fatemeh;Zhang, Huanrong;Su, Bo;Zhi, Xiuyi;Quesenberry, Charles P.;Habel, Laurel A.;Deng, Qiuhua;Wang, Zongfei;Zhou, Jiangfen;Li, Huiling;Huang, Mei-Chun;Yeh, Che-Chung;Segal, Mark R.;Ray, M. Roshni;Jones, Kirk D.;Raz, Dan J.;Xu, Zhidong;Jahan, Thierry M.;Berryman, David;He, Biao;Mann, Michael J.;Jablons, David M.
通讯作者：
Jablons, David M.
影响因子：
7.2
作者：
DEYO, RA;CHERKIN, DC;CIOL, MA
通讯作者：
CIOL, MA
影响因子：
7.2
作者：
Klabunde, CN;Potosky, AL;Warren, JL
通讯作者：
Warren, JL
影响因子：
158.5
作者：
Bach, PB;Cramer, LD;Begg, CB
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Begg, CB
影响因子：
3
作者：
Elixhauser, A;Steiner, C;Coffey, RN
通讯作者：
Coffey, RN