ArticleWorld journal of surgical oncology2025
Risk factors and clinical risk stratification of distant metastasis in early-stage lung cancer in never smokers.
Article in World journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Vitexin antagonizes the kynurenine pathway via AhR inhibition to reprogram tumor-associated macrophages and enhance antitumor immunity in lung adenocarcinoma.Molecular and cellular biochemistry · 2026Article
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6 authors.
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Abstract
backgroundRisk factors for distant metastasis in early-stage lung cancer in never smokers (LCINS) remain poorly understood. This study aimed to identify key risk factors and to develop a clinical risk stratification model for early-stage LCINS.
methodsWe retrospectively analyzed patients diagnosed with early-stage LCINS at West China Hospital, Sichuan University, from 2015 to 2020. Univariable and multivariable Cox regression analyses were performed to identify independent risk factors for distant metastasis. A predictive model was developed and internally validated using bootstrap resampling, with performance assessed by the concordance index (C-index), area under the receiver operating characteristic curve (AUC), calibration plot, and decision curve analysis.
resultsA total of 1,406 patients with pathological stage I-II LCINS were included, among whom 76 (5.41%) developed distant metastasis during follow-up. Multivariable Cox regression analysis revealed that independent risk factors included advanced pathological T and N stages, higher consolidation-to-tumor ratio, and histologic subtype, particularly solid/micropapillary predominant adenocarcinoma. Based on these predictors, a predictive model was developed, demonstrating strong discrimination with a C-index of 0.799 and AUC values of 0.809, 0.791, and 0.783 for predicting 1-, 2-, and 3-year distant metastasis, respectively. Calibration and decision curve analyses confirmed the reliability and clinical utility of the model.
conclusionsThis study identified risk factors and developed a clinical risk stratification model for distant metastasis in early-stage LCINS. This validated model enables risk stratification and personalized monitoring to facilitate early detection of distant recurrence in LCINS.
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