Development and validation of an inflammatory-immune-nutritional integrated scoring system: a novel strategy for predicting postoperative survival in non-small cell lung cancer

Background: Accurate prognosis prediction is crucial for managing non-small cell lung cancer (NSCLC). Tumor heterogeneity limits the predictive power of traditional tumor lymph node metastasis (TNM) staging alone. The interplay between inflammation, immunity, and nutrition in the tumor microenvironment offers a potential source of novel prognostic biomarkers. Methods: = 134). A prognostic nomogram incorporating IINS and clinicopathological factors was constructed and evaluated using time-dependent receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA). Results: = 0.039). The nomogram demonstrated good predictive accuracy, with 1-, 3-, and 5-year area under the curves (AUCs) for OS ranging from 0.695 to 0.730 in the validation cohort. DCA confirmed the nomogram's superior clinical utility compared to the TNM staging system. Conclusions: The novel IINS, integrating inflammatory, immune, and nutritional status, is a robust independent prognostic indicator for resected NSCLC. The developed nomogram provides a user-friendly and accurate tool for predicting postoperative survival, potentially aiding in risk stratification and personalized adjuvant therapy decisions.