Currently submitted to: JMIR Cancer
Date Submitted: Nov 10, 2025
Open Peer Review Period: Nov 17, 2025 - Jan 12, 2026
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Construction and evaluation of a risk prediction model for overall survival in patients with multiple primary lung cancer: a SEER database analysis
ABSTRACT
Background:
With the rapid development of medical technology and the emphasis on early lung cancer screening, the incidence of multiple primary lung cancer (MPLC) has increased in recent years. However, the prognostic determinants and clinical characteristics of MPLC patients remain poorly characterized.
Objective:
This study aimed to develop and validate a nomogram for predicting overall survival (OS) in MPLC patients using data from the Surveillance, Epidemiology, and End Results (SEER) database.
Methods:
This study was reported in accordance with the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) guideline. A cohort of 4,177 MPLC patients (2007–2015) was collected from the Surveillance, Epidemiology and End Results (SEER) database. The patients were randomly divided into training (n=2,923) and validation (n=1,254) cohorts at a 7:3 ratio. Backward stepwise Cox regression identified 11 independent risk factors, which were integrated into a nomogram predicting 3-, 5-, and 8-year OS rates.
Results:
The nomogram demonstrated superior discriminative ability compared to the AJCC staging system, with higher AUC values for 3-/5-/8-year overall survival (OS) predictions in both cohorts (training cohort: 0.743, 0.751, 0.759; validation cohort: 0.737, 0.734, 0.695). Calibration curves and decision curve analysis confirmed its clinical utility.
Conclusions:
This study establishes a validated nomogram incorporating clinical and socioeconomic variables to optimize prognostic assessment and personalized treatment planning for MPLC patients.
Citation
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