Establish and validate a nomogram prognostic model for young patients with stage IV lung adenocarcinoma

A nomogram model was established and validated to predict the prognosis of young patients with stage IV LUAD at initial diagnosis individually and precisely, demonstrating superior performance to the traditional TNM staging system. This study included young patients diagnosed with stage IV LUAD from 2010 to 2015 in the SEER database, which divided into training cohort and internal validation cohort. Additional patients from the Fourth Hospital of Hebei Medical University were included as the external validation cohort. Univariate and multivariate Cox regression analyses were performed in the training cohort to identify independent risk factors affecting survival, which was used to establish a nomogram model. The effectiveness of the model was evaluated by C-index, calibration curve, ROC curve, DCA curve, and Kaplan-Meier survival curve. DCA analysis indicated that the model's net benefit was significantly higher than that of the TNM staging system. In clinical work, this model provides valuable guidance and accurate prediction for the condition assessment and treatment decision of these patients.