A nomogram predicting the risks of distant metastasis following postoperative radiotherapy for uterine cervical carcinoma

A Korean radiation oncology group study (KROG 12-08)

Hyoung Uk Je, Seungbong Han, Young Seok Kim, Joo Hyun Nam, Hak Jae Kim, Jae Weon Kim, Won Park, Duk Soo Bae, Jin Hee Kim, So Jin Shin, Juree Kim, Ki Heon Lee, Mee Sun Yoon, Seok Mo Kim, Ji Yoon Kim, Won Sup Yoon, Nak Woo Lee, Jin Hwa Choi, Sang Yoon Park, Joo Young Kim

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose To develop a nomogram predicting the risks of distant metastasis following postoperative adjuvant radiation therapy for early stage cervical cancer. Materials and methods We reviewed the medical records of 1069 patients from ten participating institutions. Patients were divided into two cohorts: a training set (n = 748) and a validation set (n = 321). The demographic, clinical, and pathological variables were included in the univariate Cox proportional hazards analysis. Clinically established and statistically significant prognostic variables were utilized to develop a nomogram. Results The model was constructed using four variables: histologic type, pelvic lymph node involvement, depth of stromal invasion, and parametrial invasion. This model demonstrated good calibration and discrimination, with an internally validated concordance index of 0.71 and an externally validated c-index of 0.65. Compared to FIGO staging, which showed a broad range in terms of distant metastasis, the developed nomogram can accurately predict individualized risks based on individual risk factors. Conclusions The devised model offers a significantly accurate level of prediction and discrimination. In clinical practice it could be useful for counseling patients and selecting the patient group who could benefit from more intensive/further chemotherapy, once validated in a prospective patient cohort.

Original languageEnglish
Pages (from-to)437-441
Number of pages5
JournalRadiotherapy and Oncology
Volume111
Issue number3
DOIs
Publication statusPublished - 2014 Jan 1

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Nomograms
Radiation Oncology
Radiotherapy
Neoplasm Metastasis
Carcinoma
Uterine Cervical Neoplasms
Calibration
Medical Records
Counseling
Lymph Nodes
Demography
Drug Therapy

Keywords

  • Adjuvant radiotherapy
  • Nomogram
  • Uterine cervical cancer

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

A nomogram predicting the risks of distant metastasis following postoperative radiotherapy for uterine cervical carcinoma : A Korean radiation oncology group study (KROG 12-08). / Je, Hyoung Uk; Han, Seungbong; Kim, Young Seok; Nam, Joo Hyun; Kim, Hak Jae; Kim, Jae Weon; Park, Won; Bae, Duk Soo; Kim, Jin Hee; Shin, So Jin; Kim, Juree; Lee, Ki Heon; Yoon, Mee Sun; Kim, Seok Mo; Kim, Ji Yoon; Yoon, Won Sup; Lee, Nak Woo; Choi, Jin Hwa; Park, Sang Yoon; Kim, Joo Young.

In: Radiotherapy and Oncology, Vol. 111, No. 3, 01.01.2014, p. 437-441.

Research output: Contribution to journalArticle

Je, HU, Han, S, Kim, YS, Nam, JH, Kim, HJ, Kim, JW, Park, W, Bae, DS, Kim, JH, Shin, SJ, Kim, J, Lee, KH, Yoon, MS, Kim, SM, Kim, JY, Yoon, WS, Lee, NW, Choi, JH, Park, SY & Kim, JY 2014, 'A nomogram predicting the risks of distant metastasis following postoperative radiotherapy for uterine cervical carcinoma: A Korean radiation oncology group study (KROG 12-08)', Radiotherapy and Oncology, vol. 111, no. 3, pp. 437-441. https://doi.org/10.1016/j.radonc.2014.03.025
Je, Hyoung Uk ; Han, Seungbong ; Kim, Young Seok ; Nam, Joo Hyun ; Kim, Hak Jae ; Kim, Jae Weon ; Park, Won ; Bae, Duk Soo ; Kim, Jin Hee ; Shin, So Jin ; Kim, Juree ; Lee, Ki Heon ; Yoon, Mee Sun ; Kim, Seok Mo ; Kim, Ji Yoon ; Yoon, Won Sup ; Lee, Nak Woo ; Choi, Jin Hwa ; Park, Sang Yoon ; Kim, Joo Young. / A nomogram predicting the risks of distant metastasis following postoperative radiotherapy for uterine cervical carcinoma : A Korean radiation oncology group study (KROG 12-08). In: Radiotherapy and Oncology. 2014 ; Vol. 111, No. 3. pp. 437-441.
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AU - Nam, Joo Hyun

AU - Kim, Hak Jae

AU - Kim, Jae Weon

AU - Park, Won

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AU - Kim, Jin Hee

AU - Shin, So Jin

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AU - Lee, Ki Heon

AU - Yoon, Mee Sun

AU - Kim, Seok Mo

AU - Kim, Ji Yoon

AU - Yoon, Won Sup

AU - Lee, Nak Woo

AU - Choi, Jin Hwa

AU - Park, Sang Yoon

AU - Kim, Joo Young

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N2 - Purpose To develop a nomogram predicting the risks of distant metastasis following postoperative adjuvant radiation therapy for early stage cervical cancer. Materials and methods We reviewed the medical records of 1069 patients from ten participating institutions. Patients were divided into two cohorts: a training set (n = 748) and a validation set (n = 321). The demographic, clinical, and pathological variables were included in the univariate Cox proportional hazards analysis. Clinically established and statistically significant prognostic variables were utilized to develop a nomogram. Results The model was constructed using four variables: histologic type, pelvic lymph node involvement, depth of stromal invasion, and parametrial invasion. This model demonstrated good calibration and discrimination, with an internally validated concordance index of 0.71 and an externally validated c-index of 0.65. Compared to FIGO staging, which showed a broad range in terms of distant metastasis, the developed nomogram can accurately predict individualized risks based on individual risk factors. Conclusions The devised model offers a significantly accurate level of prediction and discrimination. In clinical practice it could be useful for counseling patients and selecting the patient group who could benefit from more intensive/further chemotherapy, once validated in a prospective patient cohort.

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