Prognostic Model for Predicting Survival in Non Small Cell Lung Cancer Patients

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This nomogram was built by Cox proportional hazard model based on the variables: gender, cell histology, ECOG performance status, metastasis to the skin, liver, and peritoneum, hemoglobin level, white blood cell concentration, and lymphocyte percentage. A risk score is generated by each patient, the higher of which represents higher chance of worse prognosis. The graph represents predicted survival probability over time.

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The total points represents the sum of the 6 independent poor prognostic factors from the Hoang et al1 multivariate analysis. The paper provided a nomogram for estimating one-year and two-year survival rates, which was fitted in a polynomial regression model to create the plot above.

Each factor is given a point value to use for the nomogram: Subcutaneous metastasis - 66, lower performance status (ECOG 1 or 2) - 43, loss of appetite - 38, liver metastasis - 35, ≥ four metastatic sites - 19, no previous lung surgery - 15. The higher total points, the less likely the patient will survive.

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The survival curve and table values are estimated from Paesmans et al2 Figure 3. To view how patient groups are organized, go to the Tree Diagram tab above.

Tree diagram as replicated from Paesmans et al2 manuscript for the entire population (Fig. 2). For specific survival rates at a certain time, go to Survival Rate Plot tab above.
Abbreviations: WBC, white blood cell count; PS, ECOG performance status; NC, neutrophil count; WL, weight loss.

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Tree diagram as replicated from Albain et al3 manuscript for Recent Extensive Non-Small Cell Patients (Fig. 1).
Abbreviations: LDH, lactate dehydrogenase; HGB, hemoglobin.

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This binary prognostic model from Finkelstein et al4 gives a score to each positive prognostic factor. The scores are totaled and the calculated score is found using a formula provided in the appendix of the paper. The model predicts that the patient will survive for one year if the calculated value is above a certain threshold as represented by the red line.

The Wang nomogram for NSCLC patients in advanced stage on the UT Southwestern QBRC website is a resource mainly for biomedical research. It should not be used directly in any medical diagnosis or treatment decisions but is only to be used as an tool in understanding progression and prognosis of NSCLC disease in research context. A doctor should always be consulted for professional medical opinion. In using this web server, you agree that neither UT Southwestern nor any other party is or will be liable or otherwise responsible for any action taken or not taken due to your use of this nomogram.

For more information, please contact: Tao Wang (tao.wang@utsouthwestern.edu)

Citation:

Download the fitted Coxph model (Wang et al nomogram) in R
An R object "fit" is contained in the RData file, which is generated by the coxph function

References:

1. Hoang, T., Xu, R., Schiller, J.H., Bonomi, P. and Johnson, D.H. (2005) Clinical model to predict survival in chemonaive patients with advanced non-small-cell lung cancer treated with third-generation chemotherapy regimens based on eastern cooperative oncology group data. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 23, 175-183.
2. Paesmans, M., Sculier, J.P., Libert, P., Bureau, G., Dabouis, G., Thiriaux, J., Michel, J., Van Cutsem, O., Sergysels, R., Mommen, P. et al. (1995) Prognostic factors for survival in advanced non-small-cell lung cancer: univariate and multivariate analyses including recursive partitioning and amalgamation algorithms in 1,052 patients. The European Lung Cancer Working Party. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 13, 1221-1230.
3. Albain, K.S., Crowley, J.J., LeBlanc, M. and Livingston, R.B. (1991) Survival determinants in extensive-stage non-small-cell lung cancer: the Southwest Oncology Group experience. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 9, 1618-1626.
4. Finkelstein, D.M., Ettinger, D.S. and Ruckdeschel, J.C. (1986) Long-term survivors in metastatic non-small-cell lung cancer: an Eastern Cooperative Oncology Group Study. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 4, 702-709.