Predicting Lymph Node Metastasis in Non-small Cell Lung Cancer Prospective External and Temporal Validation of the HAL and HOMER Models

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dc.contributor.authorMartinez-Zayas, Gabriela
dc.contributor.authorAlmeida, Francisco A.
dc.contributor.authorYarmus, Lonny
dc.contributor.authorSteinfort, Daniel
dc.contributor.authorLazarus, Donald R.
dc.contributor.authorSimoff, Michael J.
dc.contributor.authorSaettele, Timothy
dc.contributor.authorMurgu, Septimiu
dc.contributor.authorDammad, Tarek
dc.contributor.authorDuong, D. Kevin
dc.contributor.authorMudambi, Lakshmi
dc.contributor.authorFilner, Joshua J.
dc.contributor.authorMolina, Sofia
dc.contributor.authorAravena, Carlos
dc.contributor.authorThiboutot, Jeffrey
dc.contributor.authorBonney, Asha
dc.contributor.authorRueda, Adriana M.
dc.contributor.authorDebiane, Labib G.
dc.contributor.authorHogarth, D. Kyle
dc.contributor.authorBedi, Harmeet
dc.contributor.authorDeffebach, Mark
dc.contributor.authorSagar, Ala-Eddin S.
dc.contributor.authorCicenia, Joseph
dc.contributor.authorYu, Diana H.
dc.contributor.authorCohen, Avi
dc.contributor.authorFrye, Laura
dc.contributor.authorGrosu, Horiana B.
dc.contributor.authorGildea, Thomas
dc.contributor.authorFeller-Kopman, David
dc.contributor.authorCasal, Roberto F.
dc.contributor.authorMachuzak, Michael
dc.contributor.authorArain, Muhammad H.
dc.contributor.authorSethi, Sonali
dc.contributor.authorEapen, George A.
dc.contributor.authorLam, Louis
dc.contributor.authorJimenez, Carlos A.
dc.contributor.authorRibeiro, Manuel
dc.contributor.authorNoor, Laila Z.
dc.contributor.authorMehta, Atul
dc.contributor.authorSong, Juhee
dc.contributor.authorChoi, Humberto
dc.contributor.authorMa, Junsheng
dc.contributor.authorLi, Liang
dc.contributor.authorOst, David E.
dc.date.accessioned2025-01-20T22:08:31Z
dc.date.available2025-01-20T22:08:31Z
dc.date.issued2021
dc.description.abstractBACKGROUND: Two models, the Help with the Assessment of Adenopathy in Lung cancer (HAL) and Help with Oncologic Mediastinal Evaluation for Radiation (HOMER), were recently developed to estimate the probability of nodal disease in patients with non-small cell lung cancer (NSCLC) as determined by endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA). The objective of this study was to prospectively externally validate both models at multiple centers.
dc.description.abstractRESEARCH QUESTION: Are the HAL and HOMER models valid across multiple centers?
dc.description.abstractSTUDY DESIGN AND METHODS: This multicenter prospective observational cohort study enrolled consecutive patients with PET-CT clinical-radiographic stages T1-3, N0-3, M0 NSCLC undergoing EBUS-TBNA staging. HOMER was used to predict the probability of N0 vs N1 vs N2 or N3 (N2 vertical bar 3) disease, and HAL was used to predict the probability of N2 vertical bar 3 (vs N0 or N1) disease. Model discrimination was assessed using the area under the receiver operating characteristics curve (ROC-AUC), and calibration was assessed using the Brier score, calibration plots, and the Hosmer-Lemeshow test.
dc.description.abstractRESULTS: Thirteen centers enrolled 1,799 patients. HAL and HOMER demonstrated good discrimination: HAL ROC-AUC = 0.873 (95%CI, 0.856-0.891) and HOMER ROC-AUC = 0.837 (95%CI, 0.814-0.859) for predicting N1 disease or higher (N1 vertical bar 2 vertical bar 3) and 0.876 (95%CI, 0.855-0.897) for predicting N2 vertical bar 3 disease. Brier scores were 0.117 and 0.349, respectively. Calibration plots demonstrated good calibration for both models. For HAL, the difference between forecast and observed probability of N2 vertical bar 3 disease was +0.012; for HOMER, the difference for N1 vertical bar 2 vertical bar 3 was -0.018 and for N2 vertical bar 3 was +0.002. The Hosmer-Lemeshow test was significant for both models (P = .034 and .002), indicating a small but statistically significant calibration error.
dc.description.abstractINTERPRETATION: HAL and HOMER demonstrated good discrimination and calibration in multiple centers. Although calibration error was present, the magnitude of the error is small, such that the models are informative.
dc.description.funderCancer Center Support Grant (NCI)
dc.fuente.origenWOS
dc.identifier.doi10.1016/j.chest.2021.04.048
dc.identifier.eissn1931-3543
dc.identifier.issn0012-3692
dc.identifier.urihttps://doi.org/10.1016/j.chest.2021.04.048
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/94298
dc.identifier.wosidWOS:000694720600066
dc.issue.numero3
dc.language.isoen
dc.pagina.final1120
dc.pagina.inicio1108
dc.revistaChest
dc.rightsacceso restringido
dc.subjectendobronchial ultrasound
dc.subjectlung cancer
dc.subjectlung cancer staging
dc.subjectmediastinal adenopathy
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titlePredicting Lymph Node Metastasis in Non-small Cell Lung Cancer Prospective External and Temporal Validation of the HAL and HOMER Models
dc.typeartículo
dc.volumen160
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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