Nomogram for predicting recurrence and metastasis of stage IA lung adenocarcinoma treated by videoassisted thoracoscopic lobectomy

ObjectiveThis study aimed to construct a nomogram to effectively predict recurrence and metastasis in patients with stage 1A lung adenocarcinoma after video-assisted thoracoscopic surgery (VATS) lobectomy.MethodsOur study included 337 patients. The 3-year recurrence-free survival rate and the 5-year recurrence-free survival (5-RFS) rate were analyzed. Multivariate Cox proportional hazards regression was conducted to identify independent risk factors. We established a nomogram and performed Harrell’s Concordance index, calibration plots, integrated discrimination improvement, and decision curve analyses to assess its discrimination and calibration.ResultsThe median follow-up time was 45 months. In a multivariate analysis, tumor diameter, pathological subtype, preoperative carcinoembryonic antigen level, and preoperative CYFRA21-1 level were independent prognostic factors for RFS (P < 0.05). These risk factors were used to construct a nomogram to predict postoperative recurrence and metastasis in these patients. Internal verification was performed using the bootstrap method. The C-index was 0.946 (95% confidence interval: 0.923–0.970), indicating that the model had a good predictive performance. Using the nomogram and X-tile software, the patients were divided into two groups: the high-risk (5-RFS rate, 0.10–0.90) and low-risk groups (5-RFS rate, 0.90–0.99); the difference in the RFS rate between the groups was significant (χ2 = 86.705, P < 0.001).ConclusionsOur nomogram had a better predictive ability for recurrence and metastasis in patients with stage 1A lung adenocarcinoma after VATS lobectomy resection than the Tumor–Node–Metastasis staging system and other predictive models. This nomogram can help provide individualized treatment strategies and follow-up times.