Development and Validation of Nomograms to Predict Overall Survival and Cancer-Specific Survival for Non-Small Cell Lung Cancer with Chest Wall Invasion: A Retrospective Study Based on SEER Database.

[BACKGROUND] Chest wall invasion is a relatively kind of infrequent direct tumor extension in non-small cell lung cancer (NSCLC) with a poor survival outcome. Risk factors that impact overall survival (OS) and cancer-specific survival (CSS) remain unclear. We aimed to explore prognostic factors and construct predictive nomograms to predict both OS and CSS in NSCLC patients with chest wall invasion.

[METHODS] We extracted a total of 2091 patients between 2010 and 2015 from the SEER database. The total patients were divided into the training cohort (1463 patients) and the validation cohort (628 patients). Univariate and multivariate Cox regression analyses were applied to distinguish the independent prognostic factors. Two prognostic nomograms for OS and CSS were established. The concordance index (C-index), receiver operating characteristic curves (ROC), calibration curves, and decision curve analysis (DCA) curves were applied to assess the performance of these two nomograms.

[RESULTS] After analysis, age, sex, histology, grade, N stage, M stage, surgery, and chemotherapy were identified as independent prognostic factors for OS, meanwhile, age, histology, grade, N stage, M stage, surgery, and chemotherapy for CSS. The C-index for OS in the training and validation cohorts was 0.711 and 0.716, respectively. The C-index for CSS was 0.721 and 0.726, respectively. The ROC curves, calibration curves, DCA curves, and K-M survival curves also exhibited good predictive performance.

[CONCLUSION] Two nomograms provide a useful tool to predict both OS and CSS in NSCLC patients with chest wall invasion.