Nomogram for Predicting Recurrence-Free Survival in Chinese Women with Endometrial Cancer after Initial Therapy: External Validation

Abstract

This study aimed at developing an available recurrence-free survival (RFS) model of endometrial cancer (EC) for accurate and individualized prognosis assessment. A training cohort of 520 women with EC who underwent initial surgical treatment and an external validation cohort of 445 eligible EC patients from 2006 to 2016 were analyzed retrospectively. Multivariable Cox proportional hazards regression models were used to develop nomograms for predicting recurrence. The concordance index (C-index) and the area under the receiver operating characteristic curve (AUC) were calculated to determine the discrimination of RFS prognostic scoring systems. Calibration plots were generated to examine the performance characteristics of the predictive nomograms. Regression analysis revealed that an advanced International Federation of Gynecology and Obstetrics (FIGO) stage, histological grade 3, primary tumor diameter ≥2 cm, and positive peritoneal cytology were independent prognostic factors for RFS in EC in the training set. The nomograms estimated RFS according to these four variables, with a C-index of 0.860, which was superior to that of FIGO stage (2009 criteria), at 0.809 (P=0.034), in the training cohort. Encouragingly, consistent results were observed in the validation set, with a C-index of 0.875 for the nomogram and a C-index of 0.833 for the FIGO staging (P=0.0137). Furthermore, the calibrations of the nomograms predicting 3- and 5-year RFS strongly corresponded to the actual survival outcome. In conclusion, this study developed an available nomogram with effective external validation and relatively appreciable discrimination and conformity for the accurate assessment of 3- and 5-year RFS in Chinese women with EC.

A nomogram for predicting overall survival in patients with endometrial carcinoma: A SEER‐based study

“…Those aged over 80 years had a high risk and a shorter OS (50–59 years: hazard ratio [HR] 1.93, 95% confidence interval [CI] 1.61–2.32; ≥80 years: HR 8.39, 95% CI 6.98–10.07). This finding was consistent with the results of other studies, 8,10,11 except for Bendifallah et al, 9 who indicated by a nomogram that the level of evidence for an association with OS for age was inconclusive. Research by Kang et al 12 showed that para‐aortic lymph node metastasis was not associated with age.…”

Survival rate of positive peritoneal cytology in endometrial cancer; a systematic review and meta-analysis

“…Of these 65 studies, 27 papers met the criteria for meta-analysis, which included an overall number of 75897 patients. Of the 27 papers, 16 studies (11,13,21,22,24,35,36,43,49,54,58,62,68,70,73,77) included OS data, 18 had DFS data(14,21,62,64,68,70,72,74,77,78,25,36,39,43,44,49,53,58), and 7 had CSS(7)(19)(33)(44)(45)(64)(73). The quality assessment (QUIPS) of included studies is summarized in table 1.…”

Development and validation of a prognostic model based on metabolic risk score to predict overall survival of endometrial cancer in Chinese patients

“…However, FIGO staging system has limitations in accurately predicting the prognosis of EC patients. Especially, it cannot explain why patients with the same stage and grade have different clinical outcomes [ 17 ]. The reason may be that ignoring the influence of other prognostic factors.…”