Risk assessment model for overall survival in patients with locally advanced cervical cancer treated with definitive concurrent chemoradiotherapy

Shim, Seung‐Hyuk; Lee, Shin-Wha; Park, Jeong-Yeol; Kim, Young Seok; Kim, Dae-Yeon; Kim, Jong-Hyeok; Kim, Yong‐Man; Kim, Young‐Tak; Nam, Joo‐Hyun

doi:10.1016/j.ygyno.2012.09.033

Cited by 42 publications

(31 citation statements)

References 34 publications

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“…A nomogram is a predictive tool that generates the numerical probability of a clinical event by creating a simple graphical representation of a statistical predictive model [22]. Several prognostic models have been developed to predict mortality, cause-specific mortality, disease recurrence, and distant or paraaortic recurrence over a specific duration in patients diagnosed with locally advanced cervical cancer treated with CCRT [14][15][16][17][18][19]23]. Various types of prognostic factors-such as age, race, FIGO stage, histological type, degree of differentiation, lymph node involvement and location, tumor volume, SUVmax of cervical tumor, serum SCC antigen levels, and treatment received-have been used as components of the prognostic predictive models [24].…”

Section: Discussionmentioning

confidence: 99%

“…In our study, age, FIGO stage, tumor size, serum SCC antigen levels, pSUVmax, nSUVmax, and HPV status were the included prognostic factors for predicting 2-year DFS and 5-year OS. Most previous studies only applied clinicopathological parameters to prognostic nomogram [14][15][16][17][18]. Only one study applied metabolic parameters obtained from 18 F-FDG PET/CT to the prognostic nomogram for locally advanced cervical cancer patients treated with CCRT [19].…”

Section: Discussionmentioning

confidence: 99%

“…Nomograms have been used to estimate oncological outcomes for locally advanced cervical cancers treated with CCRT [14][15][16][17][18]. However, only one study has reported 18 F-FDG PET/CT-based prognostic nomograms for locally advanced cervical cancer [19].…”

Section: Introductionmentioning

confidence: 99%

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Prognosis-Predicting Model Based on [18F]fluorodeoxyglucose PET Metabolic Parameters in Locally Advanced Cervical Cancer Patients Treated with Concurrent Chemoradiotherapy: Multi-Center Retrospective Study

Lee

Chong

Jeong

et al. 2020

JCM

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This study aimed to develop a prognosis-predicting model based on [18F]fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and clinicopathologic factors in locally advanced cervical cancer patients treated with concurrent chemoradiotherapy (CCRT). The medical records of 270 locally advanced cervical cancer patients who were treated with CCRT were collected from three institutions and reviewed retrospectively. A nomogram was used for predicting 2-year disease-free survival (DFS) and 5-year overall survival (OS) based on Cox proportional hazards regression. Predictor variables included nodal maximum standardized uptake value (SUVmax), primary tumor SUVmax, age, tumor size, stage, serum squamous cell carcinoma antigen level, and human papillomavirus status. Internal nomogram validation was performed. A nomogram for predicting the 2-year DFS and 5-year OS was constructed using six and seven parameters, respectively. With a focus on 2-year DFS, our model found nodal SUVmax to be the highest weighted negative prognostic factor. With a focus on 5-year OS, young age was the highest weighted negative prognostic factor. The concordance index was 0.75 and 0.78 for the 2-year DFS and 5-year OS, respectively. This nomogram is a predictive tool that can be used to counsel patients for predicting survival outcomes. Moreover, our prognosis-predicting model may make it possible to personalize treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prognosis-Predicting Model Based on [18F]fluorodeoxyglucose PET Metabolic Parameters in Locally Advanced Cervical Cancer Patients Treated with Concurrent Chemoradiotherapy: Multi-Center Retrospective Study

Lee

Chong

Jeong

et al. 2020

JCM

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“…The nomogram was built as described previously (Iasonos et al , 2008; Shim et al , 2013). Before developing the nomogram, low risk was defined as a predicted probability of developing LNM of <5% (Lyman et al , 2005; Berek and Hacker, 2010).…”

Section: Methodsmentioning

confidence: 99%

Preoperative nomogram for the identification of lymph node metastasis in early cervical cancer

Kim

Shim

et al. 2013

Br J Cancer

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Background:The objective of this study is to construct a preoperative nomogram predicting lymph node metastasis (LNM) in early-cervical cancer patients.Methods:Between 2009 and 2012, 493 early-cervical cancer patients received hysterectomy and pelvic/para-aortic lymphadenectomy. Patients who were diagnosed during 2009–2010 were assigned to a model-development cohort (n=304) and the others were assigned to a validation cohort (n=189). A multivariate logistic model was created from preoperative clinicopathologic data, from which a nomogram was developed and validated. A predicted probability of LNM<5% was defined as low risk.Results:Age, tumour size assessed by magnetic resonance imaging, and LNM assessed by positron emission tomography/computed tomography were independent predictors of nodal metastasis. The nomogram incorporating these three predictors demonstrated good discrimination and calibration (concordance index=0.878; 95% confidence interval (CI), 0.833−0.917). In the validation cohort, the discrimination accuracy was 0.825 (95% CI, 0.736−0.895). In the model-development cohort, 34% of them were classified as low risk and negative predictive value (NPV) was 99.0%. In the validation cohort, 38% were identified as low risk and NPV was 95.8%. Integrating the model-development and validation cohorts, negative likelihood ratio was 0.094 (95% CI, 0.036−0.248).Conclusion:A robust nomogram predicting LNM in early cervical cancer was developed. This model may improve clinical trial design and help physicians to decide whether lymphadenectomy should be performed.

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“…Two Korean studies evaluated the OS in groups treated with radiotherapy alone or with CCRT through a boot-strap method [7, 8]. A Taiwanese study evaluated the OS after CCRT through internal validation [9].…”

Section: Discussionmentioning

confidence: 99%

Validation of Nomograms for Survival and Metastases after Hysterectomy and Adjuvant Therapy in Uterine Cervical Cancer with Risk Factors

Yoon

Yang

Lee

et al. 2017

BioMed Research International

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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.

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Risk assessment model for overall survival in patients with locally advanced cervical cancer treated with definitive concurrent chemoradiotherapy

Cited by 42 publications

References 34 publications

Prognosis-Predicting Model Based on [18F]fluorodeoxyglucose PET Metabolic Parameters in Locally Advanced Cervical Cancer Patients Treated with Concurrent Chemoradiotherapy: Multi-Center Retrospective Study

Prognosis-Predicting Model Based on [18F]fluorodeoxyglucose PET Metabolic Parameters in Locally Advanced Cervical Cancer Patients Treated with Concurrent Chemoradiotherapy: Multi-Center Retrospective Study

Preoperative nomogram for the identification of lymph node metastasis in early cervical cancer

Validation of Nomograms for Survival and Metastases after Hysterectomy and Adjuvant Therapy in Uterine Cervical Cancer with Risk Factors

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