{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:57:41Z","timestamp":1791262661868,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lung cancer is a leading cause of cancer\u2010related mortality, and its prognosis is often affected by comorbidities such as type 2 diabetes mellitus (T2DM). This study aimed to identify survival risk factors for lung cancer patients with T2DM, evaluate the predictive models, and develop a risk score system for survival prediction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design and Methods<\/jats:title>\n                    <jats:p>We analyzed data from 5491 lung cancer patients with T2DM from the Hong Kong Hospital Authority Data Collaboration Laboratory (HADCL) (2000\u20132020). Prognostic factors were evaluated using Cox proportional hazards regression. Four algorithms were used to construct survival analysis models: Cox proportional hazards regression, LASSO Cox regression, survival tree, and random survival forests (RSF). An interpretable risk scoring system was subsequently derived using the selected predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Older age at cancer diagnosis, male sex, longer duration between T2DM diagnosis and lung cancer diagnosis (T2DM duration), smoking, alcohol consumption, history of stroke, and higher HbA1c were associated with increased mortality risk, whereas hypertension, coronary heart disease, insulin usage, anti\u2010lipid usage, and anti\u2010diabetic usage were associated with reduced mortality risk. Among the evaluated models, the RSF model demonstrated the best predictive performance, as indicated by the C\u2010index (0.71) and time\u2010dependent AUC (0.883). The developed risk score system included the following criteria: age at cancer diagnosis; T2DM duration; smoking status; HbA1c; HDL\u2010C; serum potassium (K) levels; LDL\u2010C. A score\u2009\u2265\u200975 classified 47.33% of patients as high\u2010risk, with a corresponding five\u2010year survival probability of 5.51%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among the evaluated models, the RSF model demonstrated the best predictive performance. The developed risk scoring system may support risk stratification and identification of high\u2010risk patient subgroups, potentially facilitating personalized prognostic assessment and clinical management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72164","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:44:05Z","timestamp":1787809445000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development of a Prognostic Survival Risk Score for Lung Cancer Patients With Type 2 Diabetes Mellitus: A Territory\u2010Wide Retrospective Cohort Study"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8079-3634","authenticated-orcid":false,"given":"Claire Chenwen","family":"Zhong","sequence":"first","affiliation":[{"name":"The Jockey Club School of Public Health and Primary Care, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"},{"name":"Centre for Health Education and Health Promotion, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2382-4443","authenticated-orcid":false,"given":"Junjie","family":"Huang","sequence":"additional","affiliation":[{"name":"The Jockey Club School of Public Health and Primary Care, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"},{"name":"Centre for Health Education and Health Promotion, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaojun","family":"Li","sequence":"additional","affiliation":[{"name":"The Jockey Club School of Public Health and Primary Care, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"},{"name":"Centre for Health Education and Health Promotion, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6815-5135","authenticated-orcid":false,"given":"Yu","family":"Jiang","sequence":"additional","affiliation":[{"name":"The Jockey Club School of Public Health and Primary Care, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"},{"name":"Centre for Health Education and Health Promotion, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zehuan","family":"Yang","sequence":"additional","affiliation":[{"name":"The Jockey Club School of Public Health and Primary Care, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"},{"name":"Centre for Health Education and Health Promotion, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinqiu","family":"Yuan","sequence":"additional","affiliation":[{"name":"Clinical Research Center &amp; Big Data Center The Seventh Affiliated Hospital, Sun Yat\u2010sen University  Shenzhen Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaodan","family":"Huang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010sen University Cancer Center  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8137-4201","authenticated-orcid":false,"given":"Xiaofang","family":"Liu","sequence":"additional","affiliation":[{"name":"Institute of Robotics and Automatic Information Systems, College of Artificial Intelligence Nankai University  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1253-5972","authenticated-orcid":false,"given":"Han","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology  Wuhan Hubei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Poon","sequence":"additional","affiliation":[{"name":"Information Technology and Health Informatics Division Hospital Authority  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Dou","sequence":"additional","affiliation":[{"name":"Department of Computer Science and Engineering, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8542-5026","authenticated-orcid":false,"given":"Arthur","family":"Sung","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7706-9370","authenticated-orcid":false,"given":"Martin C. 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