Objective. Although visceral pleural invasion (VPI) has already been incorporated into the TNM staging system, few studies have been conducted to evaluate the prognostic value of the extent of VPI for the survival of non-small-cell lung cancer (NSCLC) patients. Thus, we utilized the Surveillance, Epidemiology, and End Results (SEER) database to assess the correlation between the extent of VPI and survival in NSCLC. Methods. We identified and incorporated the extent of VPI to build a prognostic nomogram in this study. Patients in the SEER database diagnosed with NSCLC (n = 87,045) from 2010 to 2015 were further analyzed and randomly assigned into either the training group (n = 60,933) or validation group (n = 26,112). Clinical variables were calculated by means of multivariate Cox regressions and incorporated into the predictive model. Subsequently, the accuracy and discrimination of nomogram were further assessed through the concordance index (C-index), calibration curves, and Kaplan–Meier curves. Results. Multivariate analysis demonstrated that the extent of visceral pleural invasion was an independent and unfavorable prognostic factor. The C-indexes of the training and validation groups were 0.772 (95% CI: 0.770–0.774) and 0.769 (95% CI: 0.765–0.773), respectively, which revealed that the nomogram had sufficient credibility and stable predictive accuracy. The calibration curve displayed consistency between the actual and predictive values in both training and validation groups. Conclusion. The prognostic nomogram with the extent of VPI could offer an accurate risk evaluation for patients with NSCLC. Independent external validation of this research should be conducted in the future.

中文翻译：

---

预测非小细胞肺癌脏层胸膜浸润程度与生存率关系的列线图

客观。尽管脏层胸膜浸润 (VPI) 已纳入 TNM 分期系统，但很少有研究评估 VPI 程度对非小细胞肺癌 (NSCLC) 患者生存率的预后价值。因此，我们利用监测、流行病学和最终结果 (SEER) 数据库来评估 VPI 程度与 NSCLC 生存率之间的相关性。方法。我们确定并结合了 VPI 的范围，以在本研究中构建预后列线图。 进一步分析 SEER 数据库中 2010 年至 2015 年诊断为 NSCLC ( n = 87,045) 的患者，并随机分配到训练组 ( n  = 60,933) 或验证组 ( n = 26,112)。临床变量通过多变量 Cox 回归计算并纳入预测模型。随后，通过一致性指数（C-index）、校准曲线和 Kaplan-Meier 曲线进一步评估列线图的准确性和辨别力。结果。多因素分析表明脏层胸膜浸润程度是一个独立且不利的预后因素。训练组和验证组的 C 指数分别为 0.772（95% CI：0.770-0.774）和 0.769（95% CI：0.765-0.773），表明列线图具有足够的可信度和稳定的预测准确性。校准曲线显示了训练组和验证组中实际值和预测值之间的一致性。结论. 具有 VPI 程度的预后列线图可以为 NSCLC 患者提供准确的风险评估。这项研究的独立外部验证应在未来进行。