RT Journal Article
SR Electronic
T1 Composite anatomic-clinical-molecular prognostic model in non-small-cell lung cancer: a multicenter study of 512 patients
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP erj00286-2010
DO 10.1183/09031936.00028610
A1 López-Encuentra, A.
A1 López-Ríos, F.
A1 Conde, E.
A1 García-Luján, R.
A1 Suárez-Gauthier, A.
A1 Mañes, N.
A1 Renedo, G.
A1 Duque-Medina, J.L.
A1 García-Lagarto, E.
A1 Rami-Porta, R.
A1 González-Pont, G.
A1 Astudillo-Pombo, J.
A1 Maté-Sanz, J.L.
A1 Freixinet, J.
A1 Romero-Saavedra, T.
A1 Sánchez-Céspedes, M.
A1 Gómez de la Camara, A.
A1 ,
YR 2010
UL http://erj.ersjournals.com/content/early/2010/08/20/09031936.00028610.abstract
AB The objective is to elaborate a survival model that integrates anatomic factors, according to the 2010 seventh edition of the tumour-node-metastasis (TNM) staging, with clinical and molecular factors.Pathologic TNM-descriptors (Group A), clinical variables (Group B), laboratory parameters (Group C) and molecular markers [tissue microarrays] (Group D) were collected from 512 early NSCLC with complete resection. A multivariate analysis steped supervised learning classification algorithm was used.The prognostic performance by groups is: areas under the ROC curve (C-index): 0.67 (Group A), 0.65 (Group B), 0.57 (Group C) and 0.65 (Group D). Considering together all variables selected for each of the 4 Groups (Integrated Group) the C-index was 0.74 (95%CI, 0.70–0.79), with statistically significant differences compared with each isolated group (from p=0.006 to p<0.001). Variables with the greatest prognostic discrimination are the presence of another ipsilobar nodule and tumour size >3 cm; followed by other anatomic and clinical factors; and molecular expressions of mammalian target of rapamycin (phospho-mTOR), Ki67cell proliferation index and p-Acetil-CoA-Carboxylase.This study on early NSCLC shows the benefit from integrating pTNM, clinical and molecular factors into a composite prognostic model. The model of the Integrated Group classified patients with significantly higher accuracy compared to the TNM-2010 staging.