Development and Validation of a Nomogram for Predicting the 1-,3-,and 5-year Survival in Patients with Acinar-predominant Lung Adenocarcinoma

Objective This study aimed to develop a nomogram to predict the overall survival(OS)of patients with acinar-predominant adenocarcinoma(APA).Methods Data from patients with APA obtained from the Surveillance,Epidemiology,and End Results(SEER)database between 2008 and 2016 were used.Significant prognostic factors were incorporated to construct a nomogram for predicting the 1-,3-,and 5-year OS in these patients.The discrimination and calibration abilities of the nomogram were assessed using a C-index and calibration curves,respectively.Results A total of 2242 patients with APA were randomly divided into a training cohort(n=1576)and validation cohort(n=666).The independent prognostic factors for OS incorporated into the nomogram included marital status,age,gender,differentiation grade,T stage,N stage,and M stage.The nomogram showed good prediction capability,as indicated by the C-index[0.713,95%confidence interval(CI):0.705–0.721 in the training cohort,and 0.662,95%CI:0.649–0.775 in the validation cohort].The calibration curves demonstrated that the 1-,3-,and 5-year OS probabilities were consistent between the observed and predicted outcome frequencies.Patients were divided into the high-risk and low-risk groups with the former showing significantly worse survival than the latter(P<0.001).Conclusion Using the SEER database,a nomogram was established to predict the 1-,3-,and 5-year OS of patients with APA and was superior to the tumor size,lymph node,and metastasis staging system in terms of evaluating long-term prognosis.