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Conference Paper: Validation of survival prognostic models for non-small-cell lung cancer in stage- and age-specific groups

TitleValidation of survival prognostic models for non-small-cell lung cancer in stage- and age-specific groups
Authors
Issue Date2013
PublisherAmerican Association for Cancer Research
Citation
The 104th Annual Meeting of the American Association for Cancer Research (AACR 2013), Washington, DC., 6-10 April 2013. In Cancer Research, 2013, abstract 4707 How to Cite?
AbstractAIMS: Performance status (PS) is commonly used for patient stratification in lung cancer clinical trials. Many prognostic models have been proposed to predict survival for non-small-cell lung cancer (NSCLC). It is of interest to evaluate whether the existing prognostic models perform better than PS alone in stage- and age-specific trials for patient stratification. For stage- and age-specific groups, we aim to assess the performance of several popular prognostic models for overall survival with NSCLC trial data from Cancer Leukemia Group B (CALGB). PATIENTS AND METHODS: Data from Alliance/CALGB were used to validate the following prognostic models. Using 2979 NSCLC patients, B model (Blanchon et al 2006) was developed on a Cox regression with age, histology, PS, sex and stage (I-IV) as prognostic variables. Using 9137 surgically resected NSCLC patients, C model (Chansky et al 2009) was developed via Cox regression and recursive partitioning and amalgamation analyses with prognostic variables age, sex and stage (I-IIIA). Using 392 early stage NSCLC patients, G model (Gail et al 1984) was based on Weibull survival model with histology, PS and TN stage as prognostic variables. Using 782 advanced NSCLC patients, M model (Mandrekar at al 2006) was developed via Cox regression with prognostic variables age, BMI, hemoglobin level, PS, sex, stage (IIIB-IV), white blood cell count. In validation analysis, 1921 stage I (IA-IB) and 1108 stage IV NSCLC patients who participated in completed CALGB treatment trials and lung cancer tissue bank were included. For stage I, B, C and G models were evaluated along with the PS only model. For stage IV, B and M models were evaluated. The concordance of predicted survival times and risk scores was estimated by c-index (Harrell et al 1996). Separation of survival curves between risk groups was examined using Kaplan-Meier method and log rank test. The assessments were conducted for young (<70) and old (>=70) age groups as well as all patients combined. RESULTS: For stage 1 and young, B and PS have better survival separation than C and G with c-index for B, PS, C and G equal to 0.587, 0.567, 0.546 and 0.469. Slightly less concordant but similar findings hold for stage I and old patients with B, PS, C and G equal to 0.607, 0.586, 0.543 and 0.485. For stage IV and young, B and PS perform better than M with c-index for B, PS and M equal to 0.616, 0.594 and 0.556. Again, slightly less concordant but similar findings hold for stage IV and old patients with B, PS and M equal to 0.571, 0.552 and 0.492. CONCLUSION: Overall, B model performs better than other models for both stage I and stage IV and each age group. However, none of these prognostic models yield sufficiently better survival separation and rank concordance than the PS only model. Further research is needed to develop prognostic models significantly better than performance status alone for patient stratification in stage- and age-specific clinical trials. ©2013 American Association for Cancer Research
Persistent Identifierhttp://hdl.handle.net/10722/195786
ISSN
2015 Impact Factor: 8.556
2015 SCImago Journal Rankings: 5.372

 

DC FieldValueLanguage
dc.contributor.authorPang, HMHen_US
dc.contributor.authorGu, Linen_US
dc.contributor.authorRichards, Williamen_US
dc.contributor.authorCrawford, Jeffreyen_US
dc.contributor.authorGreen, Marken_US
dc.contributor.authorVokes, EverettEen_US
dc.contributor.authorWang, Xiaofeien_US
dc.date.accessioned2014-03-10T04:53:29Z-
dc.date.available2014-03-10T04:53:29Z-
dc.date.issued2013en_US
dc.identifier.citationThe 104th Annual Meeting of the American Association for Cancer Research (AACR 2013), Washington, DC., 6-10 April 2013. In Cancer Research, 2013, abstract 4707en_US
dc.identifier.issn0008-5472-
dc.identifier.urihttp://hdl.handle.net/10722/195786-
dc.description.abstractAIMS: Performance status (PS) is commonly used for patient stratification in lung cancer clinical trials. Many prognostic models have been proposed to predict survival for non-small-cell lung cancer (NSCLC). It is of interest to evaluate whether the existing prognostic models perform better than PS alone in stage- and age-specific trials for patient stratification. For stage- and age-specific groups, we aim to assess the performance of several popular prognostic models for overall survival with NSCLC trial data from Cancer Leukemia Group B (CALGB). PATIENTS AND METHODS: Data from Alliance/CALGB were used to validate the following prognostic models. Using 2979 NSCLC patients, B model (Blanchon et al 2006) was developed on a Cox regression with age, histology, PS, sex and stage (I-IV) as prognostic variables. Using 9137 surgically resected NSCLC patients, C model (Chansky et al 2009) was developed via Cox regression and recursive partitioning and amalgamation analyses with prognostic variables age, sex and stage (I-IIIA). Using 392 early stage NSCLC patients, G model (Gail et al 1984) was based on Weibull survival model with histology, PS and TN stage as prognostic variables. Using 782 advanced NSCLC patients, M model (Mandrekar at al 2006) was developed via Cox regression with prognostic variables age, BMI, hemoglobin level, PS, sex, stage (IIIB-IV), white blood cell count. In validation analysis, 1921 stage I (IA-IB) and 1108 stage IV NSCLC patients who participated in completed CALGB treatment trials and lung cancer tissue bank were included. For stage I, B, C and G models were evaluated along with the PS only model. For stage IV, B and M models were evaluated. The concordance of predicted survival times and risk scores was estimated by c-index (Harrell et al 1996). Separation of survival curves between risk groups was examined using Kaplan-Meier method and log rank test. The assessments were conducted for young (<70) and old (>=70) age groups as well as all patients combined. RESULTS: For stage 1 and young, B and PS have better survival separation than C and G with c-index for B, PS, C and G equal to 0.587, 0.567, 0.546 and 0.469. Slightly less concordant but similar findings hold for stage I and old patients with B, PS, C and G equal to 0.607, 0.586, 0.543 and 0.485. For stage IV and young, B and PS perform better than M with c-index for B, PS and M equal to 0.616, 0.594 and 0.556. Again, slightly less concordant but similar findings hold for stage IV and old patients with B, PS and M equal to 0.571, 0.552 and 0.492. CONCLUSION: Overall, B model performs better than other models for both stage I and stage IV and each age group. However, none of these prognostic models yield sufficiently better survival separation and rank concordance than the PS only model. Further research is needed to develop prognostic models significantly better than performance status alone for patient stratification in stage- and age-specific clinical trials. ©2013 American Association for Cancer Research-
dc.languageengen_US
dc.publisherAmerican Association for Cancer Researchen_US
dc.relation.ispartofCancer Researchen_US
dc.titleValidation of survival prognostic models for non-small-cell lung cancer in stage- and age-specific groupsen_US
dc.typeConference_Paperen_US
dc.identifier.emailPang, HMH: herbpang@hku.hken_US
dc.identifier.authorityPang, HMH=rp01857en_US
dc.identifier.doi10.1158/1538-7445.AM2013-4707-
dc.publisher.placeUnited States-

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