WCLC 2025 - Posters & ePosters-EP.04.31 Nomogram for Predicting Lung Cancer-Free Survival in Patients With Persistent Pulmonary Nodules

Pdf Summary

This study aimed to develop and validate a predictive nomogram for lung cancer-free survival (LCFS) in patients with persistent pulmonary nodules, addressing the critical need for early lung cancer detection. Researchers retrospectively analyzed data from 392 nodules in patients treated at MD Anderson Cancer Center between 2003 and 2022, followed by prospective validation in an independent cohort enrolled from 2023 to 2025. Median follow-up was 592 days.<br /><br />Using Cox regression, smaller nodule size, presence of ground-glass opacity (GGO), and absence of spiculation emerged as independent predictors of prolonged LCFS. Patients were divided into training (n=274) and validation (n=118) cohorts for model development. The nomogram demonstrated strong discrimination with concordance indices (C-index) of 0.763 in the training set and 0.731 in validation. External validation with an independent cohort of 210 patients confirmed consistent performance (C-index 0.737; 95% CI 0.652–0.805).<br /><br />Time-dependent receiver operating characteristic (ROC) analyses showed area under the curve (AUC) values of 0.775, 0.754, and 0.719 at 6, 12, and 24 months respectively, underscoring reliable predictive accuracy over time. Kaplan–Meier survival curves effectively stratified patients into distinct risk groups, demonstrating the model’s clinical relevance. Calibration plots revealed strong agreement between predicted and observed outcomes. Decision curve analysis further affirmed the clinical utility of the nomogram in guiding personalized management decisions.<br /><br />In conclusion, this validated nomogram provides a robust, clinically useful tool to predict lung cancer-free survival in patients with persistent pulmonary nodules. It can aid clinicians in risk stratification and informed decision-making for early lung cancer detection. The study was supported by the MD Anderson Moon Shot Program.

Asset Subtitle

Jianjun Zhang

Meta Tag

Speaker Jianjun Zhang

Topic Screening and Early Detection

Keywords

lung cancer-free survival

predictive nomogram

persistent pulmonary nodules

early lung cancer detection

ground-glass opacity

nodule size

spiculation

Cox regression

MD Anderson Cancer Center

risk stratification