Surgical Treatment is Still Recommended for Patients Over 75 Years with IA NSCLC: A Predictive Model Based on Surveillance, Epidemiology and End Results Database

作者：Wenting Zhang, Yafeng Liu, Jing Wu, Wenyang Wang, Jiawei Zhou, Jianqiang Guo, Qingsen Wang, Xin Zhang, Jun Xie, Yingru Xing, Dong Hu · 发表于：Cancer Control · 年份：2022 · DOI：10.1177/10732748221142750 · 被引用次数：1 · 研究领域：Gastric Cancer Management and Outcomes、Frailty in Older Adults、Lung Cancer Diagnosis and Treatment

BACKGROUND: To determine the populations who suitable for surgical treatment in elderly patients (age ≥ 75 y) with IA stage. METHODS: The clinical data of NSCLC patients diagnosed from 2010 to 2015 were collected from the SEER database and divided into surgery group (SG) and no-surgery groups (NSG). The confounders were balanced and differences in survival were compared between groups using PSM (Propensity score matching, PSM). Cox regression analysis was used to screen the independent factors that affect the Cancer-specific survival (CSS). The surgery group was defined as the patients who surgery-benefit and surgery-no benefit according to the median CSS of the no-surgery group, and then randomly divided into training and validation groups. A surgical benefit prediction model was constructed in the training and validation group. Finally, the model is evaluated using a variety of methods. RESULTS: A total of 7297 patients were included. Before PSM (SG: n = 3630; NSG: n = 3665) and after PSM (SG: n = 1725, NSG: n = 1725) confirmed that the CSS of the surgery group was longer than the no-surgery group (before PSM: 82 vs. 31 months, P < .0001; after PSM: 55 vs. 39 months, P < .0001). Independent prognostic factors included age, gender, race, marrital, tumor grade, histology, and surgery. In the surgery cohort after PSM, 1005 patients (58.27%) who survived for more than 39 months were defined as surgery beneficiaries, and the 720 patients (41.73%) were defined surgery-no benefici...