Prognosis of patients with primary malignant main stem bronchial tumors: 7,418 cases based on the SEER database

Abstract

Background

The aim of this study was to identify risk factors for patients with malignant main stem bronchial tumors (MBTs) and to develop a nomogram for predicting prognosis in those patients using data from the Surveillance, Epidemiology, and End Results (SEER) database.

Method

A process was used for case screening from the SEER database. The effect of prognostic factors on survival was evaluated using the Kaplan–Meier method and log-rank test, a competing risk model, and the Cox proportional hazards regression model. A nomogram was established for predicting 1-, 3-, and 5-year overall survival (OS) in patients with MBTs.

Results

A total of 7,418 cases were included in this study. Age, gender, pathologic grade, histologic type, tumor size, involvement of lymph nodes, tumor extension, chemotherapy, and surgery were identified as independent risk factors by univariate and multivariate analyses. A nomogram was established based on the results of the Cox model, which was validated by a C-index of 0.672 (95% CI, 0.664–0.680), and a group of calibration plots.

Conclusion

Age, gender, pathologic grade, histologic type, tumor size, involvement of lymph nodes, tumor extension, chemotherapy, and surgery were independent risk factors for OS of patients with MBTs. A nomogram was formulated to predict 1-, 3-, and 5-year OS in patients with MBTs based on individual clinical characteristics.

Keywords:

• malignant main stem bronchial tumor
• nomogram
• prognosis
• risk factors

Supplementary material

Table S1 CIF of MBT-specific death based on competing risk model

Acknowledgments

This work was supported by the National Natural Science Foundation of China (Grant numbers 81472225, 81401875 [www.nsfc.gov.cn/]), and the Research Program of Shanghai Health and Family Planning Commission (201640102 [http://www.wsjsw.gov.cn]). We thank the International Science Editing Co. for editing the language.

Author contribution

Ke Ma, Fenghao Sun, Xiaodong Yang, Cheng Zhan, and Qun Wang conceived the study design. Data acquisition was carried out by Ke Ma, Fenghao Sun, Xiaodong Yang, Shuai Wang, and Yulin Jin. Ke Ma, Fenghao Sun, Xiaodong Yang, and Cheng Zhan did the data analysis. Data interpretation was done by Shuai Wang, Lin Wang, Yu Shi, Wei Jiang, Cheng Zhan, Lin Wang, and Qun Wang. Ke Ma, Fenghao Sun, Xiaodong Yang, Yulin Jin, Yu Shi, and Wei Jiang drafted the manuscript. Revision of the manuscript was done by Yu Shi, Wei Jiang, and Qun Wang. All authors contributed toward data analysis, drafting and critically revising the paper and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.