Abstract
Objective: The aim of this study was to identify a standard for the evaluation of future models for prediction of lymph node metastasis in endometrial cancer through estimation of performance of well-known surgicopathological models. Methods: Using the medical records of 947 patients with endometrial cancer who underwent surgical management with lymphadenectomy, we retrospectively assessed the predictive performances of nodal metastasis of currently available models. Results: We evaluated three models included: 1) a model modified from the Gynecologic Oncology Group (GOG) pilot study; 2) one from the GOG-33 data; and 3) one from Mayo Clinic data. The three models showed similar negative predictive values ranging from 97.1% to 97.4%. Using Bayes' theorem, this can be translated into 2% of negative post-test probability when 10% of prevalence of lymph node metastasis was assumed. In addition, although the negative predictive value was similar among these models, the proportion that was classified as low-risk was significantly different between the studies (56.4%, 44.8%, and 30.5%, respectively; p<0.001). Conclusion: The current study suggests that a false negativity of 2% or less should be a goal for determining clinical usefulness of preoperative or intraoperative prediction models for low-risk of nodal metastasis.
Original language | English |
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Pages (from-to) | 251-256 |
Number of pages | 6 |
Journal | Journal of gynecologic oncology |
Volume | 23 |
Issue number | 4 |
DOIs | |
Publication status | Published - 2012 |
Externally published | Yes |
Keywords
- Endometrial cancer
- Low-risk group
- Lymph node dissection
- Lymphadenectomy
- Prediction
- Sensitivity and specificity
ASJC Scopus subject areas
- Oncology
- Obstetrics and Gynaecology