与肺癌转移性脊髓压迫（MSCC）患者而言，与整体健康相关的生活质量（HRQoL）对其整体幸福感至关重要。然而，目前尚缺乏针对该特定患者群体的HRQoL的普遍评估。本研究的目的是开发一个能够准确预测肺癌相关MSCC患者HRQoL结果的评分卡。研究收集了119例被诊断患有与肺癌相关的MSCC的患者进行了前瞻性分析。Least absolute shrinkage and selection operator（LASSO）回归分析，结合10倍交叉验证，用于选择最重要的变量并将其包含在评分卡中。采用一致性指数（C-index）、判别斜率、校准曲线和拟合优度检验以评估区分能力和校准能力。进行净再分类指数（NRI）和综合判别改进（IDI）分析，比较加入合并症考虑的评分卡的性能与不考虑的性能。选择了4个变量构建最终的评分卡，包括东部合作肿瘤学组（ECOG）评分、靶向治疗、焦虑量表和合并症数量。一致性指数为0.87，判别斜率为0.47，表明有较好的区分能力。校准曲线和拟合优度检验显示预测HRQoL差的概率与实际观测概率高度一致。净再分类指数（0.404，95% CI：0.074-0.734，p = 0.016）和综合判别改进（0.035，95% CI：0.004-0.066，p = 0.027）证实了考虑合并症的评分卡的优越性能。本研究开发了一种能够帮助临床医生评估肺癌相关MSCC患者术后HRQoL的预测评分卡。该评分卡为该特定患者群体的风险分层和个体化治疗规划提供了有价值的工具。版权所有 © 2023 Fu, Shi, Zhao, Cao, Cao, Lei, Su, Cui and Liu.

Health-related quality of life (HRQoL) is a critical aspect of overall well-being for patients with lung cancer, particularly those with metastatic spinal cord compression (MSCC). However, there is currently a lack of universal evaluation of HRQoL in this specific patient population. The aim of this study was to develop a nomogram that can accurately predict HRQoL outcomes in patients with lung cancer-related MSCC.A total of 119 patients diagnosed with MSCC secondary to lung cancer were prospectively collected for analysis in the study. The least absolute shrinkage and selection operator (LASSO) regression analysis, along with 10-fold cross-validation, was employed to select the most significant variables for inclusion in the nomogram. Discriminative and calibration abilities were assessed using the concordance index (C-index), discrimination slope, calibration plots, and goodness-of-fit tests. Net reclassification index (NRI) and integrated discrimination improvement (IDI) analyses were conducted to compare the nomogram's performance with and without the consideration of comorbidities.Four variables were selected to construct the final nomogram, including the Eastern Cooperative Oncology Group (ECOG) score, targeted therapy, anxiety scale, and number of comorbidities. The C-index was 0.87, with a discrimination slope of 0.47, indicating a favorable discriminative ability. Calibration plots and goodness-of-fit tests revealed a high level of consistency between the predicted and observed probabilities of poor HRQoL. The NRI (0.404, 95% CI: 0.074-0.734, p = 0.016) and the IDI (0.035, 95% CI: 0.004-0.066, p = 0.027) confirmed the superior performance of the nomogram with the consideration of comorbidities.This study develops a prediction nomogram that can assist clinicians in evaluating postoperative HRQoL in patients with lung cancer-related MSCC. This nomogram provides a valuable tool for risk stratification and personalized treatment planning in this specific patient population.Copyright © 2023 Fu, Shi, Zhao, Cao, Cao, Lei, Su, Cui and Liu.