Construction And Analysis Of Survival Prediction Model For Female Lung Adenocarcinoma Patients Based On SEER Database

Objective:In recent years,the incidence of female lung cancer patients is increasing year by year,the pathological type is mainly adenocarcinoma,and most of them have no history of smoking.The disease burden of lung cancer in non-smoking women is becoming increasingly serious.Exploring the high-risk factors of female lung adenocarcinoma patients and constructing a survival prediction model will help to further screen the high-risk population.This study used the Surveillance,Epidemiology,and Results(SEER)database of the National Cancer Institute to develop a nomogram model.For the prognostic evaluation of female patients with lung adenocarcinoma in both overall survival(OS)and cancer-specific survival(CSS).Methods:Female lung adenocarcinoma patients diagnosed between 2010 and 2015 were retrieved from the SEER database,and the relevant clinical data of 15270 patients were retrospectively analyzed.According to the ratio of 7:3,the patients were randomly assigned to the training cohort and the validation cohort.R software(version 4.2.1),R Studio,and SPSS software(version 26.0)were used for statistical analysis and mapping.Univariate and multivariate Cox regression analysis were used to screen the relevant risk factors,and the nomogram for overall survival and cancer-specific survival was constructed.The concordance index(C-index)and calibration curve were used to evaluate the nomogram model.Results:Univariate Cox analysis showed that age,race,marital status,grade,primary tumor site,T stage,N stage,M stage,bone metastasis,brain metastasis,liver metastasis,surgery,radiotherapy,and chemotherapy were the factors that affected the prognosis of female lung adenocarcinoma patients.Multivariate Cox analysis showed that age,race,grade,T stage,N stage,M stage,bone metastasis,brain metastasis,liver metastasis,surgery,and chemotherapy were independent risk factors affecting the prognosis of female lung adenocarcinoma patients.The OS and CSS of female lung adenocarcinoma patients were predicted by constructing a column graph.In the training cohort,the C index of the OS and CSS prediction nomogram were 0.759 and0.786.The concordance index showed that there was a good distinction between the predicted value and the actual value of Cox model in the survival analysis,and the calibration curve showed that the prediction model of the line graph had a good prediction fitting degree.Conclusion:This study showed that age,race,grade,T stage,N stage,M stage,bone metastasis,brain metastasis,liver metastasis,surgery,and chemotherapy were independent risk factors affecting the prognosis of female patients with lung adenocarcinoma.This study established a relatively perfect and accurate prognostic nomogram model for female patients with lung adenocarcinoma based on SEER database.After calibration and further improvement,the nomogram model can be applied in clinical practice to guide patient treatment and prognosis.