Annals of Surgical Oncology

, Volume 23, Issue 9, pp 3033–3039 | Cite as

A Nomogram to Predict Brain Metastases of Resected Non-Small Cell Lung Cancer Patients




Brain metastasis is a major cause leading to the failure of treatment management for non-small cell lung cancer (NSCLC) patients. The goal of this study was to establish an effective nomogram for prediction of brain metastases of resected NSCLC patients.


We retrospectively investigated 637 operable NSCLC patients who received treatment at Zhejiang Cancer Hospital, China. A Cox proportional hazards regression model was performed to identify significant risk factors, and a nomogram was developed for predicting 3- and 5-year brain metastases rates.


Multivariate analysis identified four independent risk factors: neuron-specific enolase, histological type, number of metastatic lymph nodes, and tumor grade, and a nomogram was developed based on these factors. The effectiveness of the nomogram was validated using an internal bootstrap resampling approach, showing that the nomogram exhibited a sufficient level of discrimination according to the C-index (0.74, 95 % confidence interval 0.67–0.82).


The nomogram developed in this study demonstrated its discrimination capability for predicting 3- and 5-year occurrence of brain metastases, and can be used to identify high-risk patients.


Brain Metastasis NSCLC Patient Metastatic Lymph Node Serum Tumor Marker Prophylactic Cranial Irradiation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This study was supported by grants from the National Nature Science Foundation of China (No. 81472203), the Major Science and Technology Project of Medical and Health of Zhejiang Province of China (No. WKJ-ZJ-1403), the Major Science and Technology Project of Zhejiang Province of China (No. 2014C03029), the Natural Science Foundation of Zhejiang Province (No. LY13H160028), the Zhejiang Provincial Medicine and Health Science Fund (Nos. 2013KYA028, 2015KYA035), and the 1022 program of Zhejiang Cancer Hospital.


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Copyright information

© Society of Surgical Oncology 2016

Authors and Affiliations

  1. 1.Cancer Research InstituteZhejiang Cancer Hospital and Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology of Zhejiang ProvinceHangzhouChina
  2. 2.School of Life SciencesJiangsu Normal UniversityXuzhouChina
  3. 3.Nanjing Medical University Affiliated Hangzhou Hospital (Hangzhou First People’s Hospital)HangzhouChina

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