Introduction: We developed one of the first clinicopathological prognostic nomograms for resected squamous cell lung cancer (SQLC). Herein, we validate the model in a larger multicenter cohort and we explore the impact of adjuvant and neoadjuvant treatment (ANT). Methods: Patients with resected SQLC from January 2002 to December 2012 in six institutions were eligible. Each patient was assigned a prognostic score based on the clinicopathological factors included in the model (age, T descriptor according to seventh edition of the TNM classification, lymph node status, and grading). Kaplan‐Meier analysis for disease‐free survival, cancer‐specific survival (CSS), and overall survival was performed according to a three‐class risk model. Harrell's C‐statistics were adopted for model validation. The effect of ANT was adjusted with propensity score. Results: Data on 1375 patients were gathered (median age, 68 years; male sex, 86.8%; T descriptor 1 or 2 versus 3 or 4, 71.7% versus 24.9%; nodes negative versus positive, 53.4% versus 46.6%; and grading of 1 or 2 versus 3, 35.0% versus 41.1%). Data for survival analysis were available for 1097 patients. With a median follow‐up of 55 months, patients at low risk had a significantly longer disease‐free survival than did patients at intermediate risk (hazard ratio [HR] = 1.67, 95% confidence interval [CI]: 1.40–2.01) and patients at high risk (HR = 2.46, 95% CI: 1.90–3.19); they also had a significantly longer CSS (HR = 2.46, 95% CI: 1.80–3.36 versus HR = 4.30, 95% CI: 2.92–6.33) and overall survival (HR = 1.79, 95% CI: 1.48–2.17 versus HR = 2.33, 95% CI: 1.76–3.07). A trend in favor of ANT was observed for intermediate‐risk/high‐risk patients, particularly for CSS (p = 0.06 [5‐year CSS 72.7% versus 60.8%]). Conclusions: A model based on a combination of easily available clinicopathological factors effectively stratifies patients with resected SQLC into three risk classes.

中文翻译：

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切除鳞状细胞肺癌的预后模型：外部多中心验证和倾向评分分析探索辅助和新辅助治疗的影响

简介：我们开发了第一个用于切除鳞状细胞肺癌 (SQLC) 的临床病理学预后列线图。在此，我们在更大的多中心队列中验证了该模型，并探讨了辅助和新辅助治疗 (ANT) 的影响。方法：纳入6家机构2002年1月至2012年12月切除的SQLC患者。根据模型中包含的临床病理因素（年龄、根据第七版 TNM 分类的 T 描述符、淋巴结状态和分级）为每位患者分配一个预后评分。根据三类风险模型对无病生存率、癌症特异性生存率 (CSS) 和总生存率进行 Kaplan-Meier 分析。模型验证采用 Harrell 的 C 统计量。ANT的影响通过倾向评分进行调整。结果：收集了 1375 名患者的数据（中位年龄，68 岁；男性，86.8%；T 描述符 1 或 2 与 3 或 4，71.7% 与 24.9%；淋巴结阴性与阳性，53.4% 与 46.6%；以及分级1 或 2 对 3，35.0% 对 41.1%）。可获得 1097 名患者的生存分析数据。中位随访 55 个月，低风险患者的无病生存期明显长于中等风险患者（风险比 [HR] = 1.67，95% 置信区间 [CI]：1.40–2.01）和高危患者（HR = 2.46，95% CI：1.90–3.19）；他们的 CSS（HR = 2.46, 95% CI: 1.80–3.36 vs HR = 4.30, 95% CI: 2.92–6.33）和总生存期（HR = 1.79, 95% CI: 1.48–2.17 vs HR = 2.33，95% 置信区间：1.76–3.07）。在中危/高危患者中观察到有利于 ANT 的趋势，特别是对于 CSS（p = 0.06 [5 年 CSS 72.7% vs 60.8%]）。结论：基于易于获得的临床病理因素组合的模型有效地将切除的 SQLC 患者分为三个风险等级。