title: Development and validation of a nomogram for predicting survival in patients with resected non-small-cell lung cancer.
abstract: OBJECTIVE
  A nomogram is a useful and convenient tool for individualized cancer prognoses. We sought to develop a clinical nomogram for predicting survival of patients with resected non-small-cell lung cancer (NSCLC).
  
  
  METHODS
  On the basis of data from a multi-institutional registry of 6,111 patients with resected NSCLC in China, we identified and integrated significant prognostic factors for survival to build a nomogram. The model was subjected to bootstrap internal validation and to external validation with a separate cohort of 2,148 patients from the International Association for the Study of Lung Cancer (IASLC) database. The predictive accuracy and discriminative ability were measured by concordance index (C-index) and risk group stratification.
  
  
  RESULTS
  A total of 5,261 patients were included for analysis. Six independent prognostic factors were identified and entered into the nomogram. The calibration curves for probability of 1-, 3-, and 5-year overall survival (OS) showed optimal agreement between nomogram prediction and actual observation. The C-index of the nomogram was higher than that of the seventh edition American Joint Committee on Cancer TNM staging system for predicting OS (primary cohort, 0.71 v 0.68, respectively; P < .01; IASLC cohort, 0.67 v 0.64, respectively; P = .06). The stratification into different risk groups allowed significant distinction between survival curves within respective TNM categories.
  
  
  CONCLUSIONS
  We established and validated a novel nomogram that can provide individual prediction of OS for patients with resected NSCLC. This practical prognostic model may help clinicians in decision making and design of clinical studies.
authors.affiliation: Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, The First Affiliated Hospital of Guangzhou Medical University; Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, Guangzhou Institute of Respiratory Disease and China State Key Laboratory of Respiratory Disease; Wenhua Liang, Li Zhang, and Zhihua Zhu, Cancer Center of Sun Yat-Sen University, Guangzhou; Gening Jiang, Shanghai Pulmonary Hospital of Tongji University; Qun Wang, Shanghai Zhongshan Hospital of Fudan University, Shanghai; Lunxu Liu, West China Hospital, Sichuan University, Chengdu; Deruo Liu, China and Japan Friendship Hospital, Beijing; and Zheng Wang, Shenzhen People's Hospital, Shenzhen, People's Republic of China.
authors.forename: Wenhua
authors.initials: W
authors.lastname: Liang
authors.affiliation: Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, The First Affiliated Hospital of Guangzhou Medical University; Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, Guangzhou Institute of Respiratory Disease and China State Key Laboratory of Respiratory Disease; Wenhua Liang, Li Zhang, and Zhihua Zhu, Cancer Center of Sun Yat-Sen University, Guangzhou; Gening Jiang, Shanghai Pulmonary Hospital of Tongji University; Qun Wang, Shanghai Zhongshan Hospital of Fudan University, Shanghai; Lunxu Liu, West China Hospital, Sichuan University, Chengdu; Deruo Liu, China and Japan Friendship Hospital, Beijing; and Zheng Wang, Shenzhen People's Hospital, Shenzhen, People's Republic of China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, The First Affiliated Hospital of Guangzhou Medical University; Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, Guangzhou Institute of Respiratory Disease and China State Key Laboratory of Respiratory Disease; Wenhua Liang, Li Zhang, and Zhihua Zhu, Cancer Center of Sun Yat-Sen University, Guangzhou; Gening Jiang, Shanghai Pulmonary Hospital of Tongji University; Qun Wang, Shanghai Zhongshan Hospital of Fudan University, Shanghai; Lunxu Liu, West China Hospital, Sichuan University, Chengdu; Deruo Liu, China and Japan Friendship Hospital, Beijing; and Zheng Wang, Shenzhen People's Hospital, Shenzhen, People's Republic of China.
authors.forename: Gening
authors.initials: G
authors.lastname: Jiang
authors.affiliation: Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, The First Affiliated Hospital of Guangzhou Medical University; Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, Guangzhou Institute of Respiratory Disease and China State Key Laboratory of Respiratory Disease; Wenhua Liang, Li Zhang, and Zhihua Zhu, Cancer Center of Sun Yat-Sen University, Guangzhou; Gening Jiang, Shanghai Pulmonary Hospital of Tongji University; Qun Wang, Shanghai Zhongshan Hospital of Fudan University, Shanghai; Lunxu Liu, West China Hospital, Sichuan University, Chengdu; Deruo Liu, China and Japan Friendship Hospital, Beijing; and Zheng Wang, Shenzhen People's Hospital, Shenzhen, People's Republic of China.
authors.forename: Qun
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, The First Affiliated Hospital of Guangzhou Medical University; Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, Guangzhou Institute of Respiratory Disease and China State Key Laboratory of Respiratory Disease; Wenhua Liang, Li Zhang, and Zhihua Zhu, Cancer Center of Sun Yat-Sen University, Guangzhou; Gening Jiang, Shanghai Pulmonary Hospital of Tongji University; Qun Wang, Shanghai Zhongshan Hospital of Fudan University, Shanghai; Lunxu Liu, West China Hospital, Sichuan University, Chengdu; Deruo Liu, China and Japan Friendship Hospital, Beijing; and Zheng Wang, Shenzhen People's Hospital, Shenzhen, People's Republic of China.
authors.forename: Lunxu
authors.initials: L
authors.lastname: Liu
authors.affiliation: Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, The First Affiliated Hospital of Guangzhou Medical University; Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, Guangzhou Institute of Respiratory Disease and China State Key Laboratory of Respiratory Disease; Wenhua Liang, Li Zhang, and Zhihua Zhu, Cancer Center of Sun Yat-Sen University, Guangzhou; Gening Jiang, Shanghai Pulmonary Hospital of Tongji University; Qun Wang, Shanghai Zhongshan Hospital of Fudan University, Shanghai; Lunxu Liu, West China Hospital, Sichuan University, Chengdu; Deruo Liu, China and Japan Friendship Hospital, Beijing; and Zheng Wang, Shenzhen People's Hospital, Shenzhen, People's Republic of China.
authors.forename: Deruo
authors.initials: D
authors.lastname: Liu
authors.affiliation: Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, The First Affiliated Hospital of Guangzhou Medical University; Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, Guangzhou Institute of Respiratory Disease and China State Key Laboratory of Respiratory Disease; Wenhua Liang, Li Zhang, and Zhihua Zhu, Cancer Center of Sun Yat-Sen University, Guangzhou; Gening Jiang, Shanghai Pulmonary Hospital of Tongji University; Qun Wang, Shanghai Zhongshan Hospital of Fudan University, Shanghai; Lunxu Liu, West China Hospital, Sichuan University, Chengdu; Deruo Liu, China and Japan Friendship Hospital, Beijing; and Zheng Wang, Shenzhen People's Hospital, Shenzhen, People's Republic of China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, The First Affiliated Hospital of Guangzhou Medical University; Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, Guangzhou Institute of Respiratory Disease and China State Key Laboratory of Respiratory Disease; Wenhua Liang, Li Zhang, and Zhihua Zhu, Cancer Center of Sun Yat-Sen University, Guangzhou; Gening Jiang, Shanghai Pulmonary Hospital of Tongji University; Qun Wang, Shanghai Zhongshan Hospital of Fudan University, Shanghai; Lunxu Liu, West China Hospital, Sichuan University, Chengdu; Deruo Liu, China and Japan Friendship Hospital, Beijing; and Zheng Wang, Shenzhen People's Hospital, Shenzhen, People's Republic of China.
authors.forename: Zhihua
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, The First Affiliated Hospital of Guangzhou Medical University; Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, Guangzhou Institute of Respiratory Disease and China State Key Laboratory of Respiratory Disease; Wenhua Liang, Li Zhang, and Zhihua Zhu, Cancer Center of Sun Yat-Sen University, Guangzhou; Gening Jiang, Shanghai Pulmonary Hospital of Tongji University; Qun Wang, Shanghai Zhongshan Hospital of Fudan University, Shanghai; Lunxu Liu, West China Hospital, Sichuan University, Chengdu; Deruo Liu, China and Japan Friendship Hospital, Beijing; and Zheng Wang, Shenzhen People's Hospital, Shenzhen, People's Republic of China.
authors.forename: Qiuhua
authors.initials: Q
authors.lastname: Deng
authors.affiliation: Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, The First Affiliated Hospital of Guangzhou Medical University; Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, Guangzhou Institute of Respiratory Disease and China State Key Laboratory of Respiratory Disease; Wenhua Liang, Li Zhang, and Zhihua Zhu, Cancer Center of Sun Yat-Sen University, Guangzhou; Gening Jiang, Shanghai Pulmonary Hospital of Tongji University; Qun Wang, Shanghai Zhongshan Hospital of Fudan University, Shanghai; Lunxu Liu, West China Hospital, Sichuan University, Chengdu; Deruo Liu, China and Japan Friendship Hospital, Beijing; and Zheng Wang, Shenzhen People's Hospital, Shenzhen, People's Republic of China.
authors.forename: Xinguo
authors.initials: X
authors.lastname: Xiong
authors.affiliation: Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, The First Affiliated Hospital of Guangzhou Medical University; Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, Guangzhou Institute of Respiratory Disease and China State Key Laboratory of Respiratory Disease; Wenhua Liang, Li Zhang, and Zhihua Zhu, Cancer Center of Sun Yat-Sen University, Guangzhou; Gening Jiang, Shanghai Pulmonary Hospital of Tongji University; Qun Wang, Shanghai Zhongshan Hospital of Fudan University, Shanghai; Lunxu Liu, West China Hospital, Sichuan University, Chengdu; Deruo Liu, China and Japan Friendship Hospital, Beijing; and Zheng Wang, Shenzhen People's Hospital, Shenzhen, People's Republic of China.
authors.forename: Wenlong
authors.initials: W
authors.lastname: Shao
authors.affiliation: Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, The First Affiliated Hospital of Guangzhou Medical University; Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, Guangzhou Institute of Respiratory Disease and China State Key Laboratory of Respiratory Disease; Wenhua Liang, Li Zhang, and Zhihua Zhu, Cancer Center of Sun Yat-Sen University, Guangzhou; Gening Jiang, Shanghai Pulmonary Hospital of Tongji University; Qun Wang, Shanghai Zhongshan Hospital of Fudan University, Shanghai; Lunxu Liu, West China Hospital, Sichuan University, Chengdu; Deruo Liu, China and Japan Friendship Hospital, Beijing; and Zheng Wang, Shenzhen People's Hospital, Shenzhen, People's Republic of China.
authors.forename: Xiaoshun
authors.initials: X
authors.lastname: Shi
authors.affiliation: Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, The First Affiliated Hospital of Guangzhou Medical University; Wenhua Liang, Qiuhua Deng, Xinguo Xiong, Wenlong Shao, Xiaoshun Shi, and Jianxing He, Guangzhou Institute of Respiratory Disease and China State Key Laboratory of Respiratory Disease; Wenhua Liang, Li Zhang, and Zhihua Zhu, Cancer Center of Sun Yat-Sen University, Guangzhou; Gening Jiang, Shanghai Pulmonary Hospital of Tongji University; Qun Wang, Shanghai Zhongshan Hospital of Fudan University, Shanghai; Lunxu Liu, West China Hospital, Sichuan University, Chengdu; Deruo Liu, China and Japan Friendship Hospital, Beijing; and Zheng Wang, Shenzhen People's Hospital, Shenzhen, People's Republic of China. drjianxing.he@gmail.com.
authors.forename: Jianxing
authors.initials: J
authors.lastname: He
mesh_terms: D000368:Aged; D000465:Algorithms; D002138:Calibration; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000601:surgery*; D002681:China; D003657:Decision Making; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D049451:Nomograms; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012042:Registries; D015203:Reproducibility of Results; D016896:Treatment Outcome