TY - JOUR
T1 - Validation of Nomograms for Survival and Metastases after Hysterectomy and Adjuvant Therapy in Uterine Cervical Cancer with Risk Factors
AU - Yoon, Won Sup
AU - Yang, Dae Sik
AU - Lee, Jung Ae
AU - Lee, Nam Kwon
AU - Park, Young Je
AU - Kim, Chul Yong
AU - Lee, Nak Woo
AU - Hong, Jin Hwa
AU - Lee, Jae Kwan
AU - Song, Jae Yun
N1 - Publisher Copyright:
© 2017 Won Sup Yoon et al.
PY - 2017
Y1 - 2017
N2 - Background. Three nomogram models for early stage uterine cervical cancer have been developed (KROG 13-03 for overall survival [OS], SNUH/AMC for disease-free survival [DFS], and KROG 12-08 for distant metastases-free survival [DMFS]) after radical hysterectomy (RH) and pelvic lymph node dissection (PLND). This study aimed to validate these models using our cohort with adjuvant radiotherapy. Methods. According to the eligibility criteria of nomogram studies, patients were enrolled in Group A (N=109) for the two KROG models (RH with PLND and whole pelvic irradiation) and Group B (N=101) for the SNUH/AMC model (RH with PLND and squamous histology). Using Cox-regression hazard models, the prognostic factors of our cohorts were evaluated. The risk probabilities induced from published nomogram scores were calculated and the concordance indices were evaluated. Results. Group A had 88.1% 5-year OS and 86.0% 5-year DMFS. Group B had 83.0% 5-year DFS. In multivariate analyses, large tumor size for OS (HR 8.62, P<0.001) and DMFS (HR 5.13, P=0.003), young age (≤40 versus 41-64 years) for OS (HR 4.63, P=0.097) and DFS (HR 3.44, P=0.051), and multiple lymph node metastases (0 versus ≥3) for DMFS (HR 4.03, P=0.031) and DFS (HR 3.90, P=0.038) were significantly correlated. The concordance indices for OS, DMFS, and DFS were 0.612 (P=0.002), 0.597 (P=0.014), and 0.587 (P=0.020), respectively. Conclusion. The developed nomogram models after RH and PLND are clinically useful in predicting various types of survival with significance.
AB - Background. Three nomogram models for early stage uterine cervical cancer have been developed (KROG 13-03 for overall survival [OS], SNUH/AMC for disease-free survival [DFS], and KROG 12-08 for distant metastases-free survival [DMFS]) after radical hysterectomy (RH) and pelvic lymph node dissection (PLND). This study aimed to validate these models using our cohort with adjuvant radiotherapy. Methods. According to the eligibility criteria of nomogram studies, patients were enrolled in Group A (N=109) for the two KROG models (RH with PLND and whole pelvic irradiation) and Group B (N=101) for the SNUH/AMC model (RH with PLND and squamous histology). Using Cox-regression hazard models, the prognostic factors of our cohorts were evaluated. The risk probabilities induced from published nomogram scores were calculated and the concordance indices were evaluated. Results. Group A had 88.1% 5-year OS and 86.0% 5-year DMFS. Group B had 83.0% 5-year DFS. In multivariate analyses, large tumor size for OS (HR 8.62, P<0.001) and DMFS (HR 5.13, P=0.003), young age (≤40 versus 41-64 years) for OS (HR 4.63, P=0.097) and DFS (HR 3.44, P=0.051), and multiple lymph node metastases (0 versus ≥3) for DMFS (HR 4.03, P=0.031) and DFS (HR 3.90, P=0.038) were significantly correlated. The concordance indices for OS, DMFS, and DFS were 0.612 (P=0.002), 0.597 (P=0.014), and 0.587 (P=0.020), respectively. Conclusion. The developed nomogram models after RH and PLND are clinically useful in predicting various types of survival with significance.
UR - http://www.scopus.com/inward/record.url?scp=85019172472&partnerID=8YFLogxK
U2 - 10.1155/2017/2917925
DO - 10.1155/2017/2917925
M3 - Article
C2 - 28536694
AN - SCOPUS:85019172472
SN - 2314-6133
VL - 2017
JO - BioMed Research International
JF - BioMed Research International
M1 - 2917925
ER -
