A Web-based nomogram predicting para-aortic nodal metastasis in incompletely staged patients with endometrial cancer: A Korean multicenter study

Sokbom Kang, Jong Min Lee, Jae Kwan Lee, Jae Weon Kim, Chi Heum Cho, Seok Mo Kim, Sang Yoon Park, Chan Yong Park, Ki Tae Kim

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective: The purpose of this study is to develop a Web-based nomogram for predicting the individualized risk of para-aortic nodal metastasis in incompletely staged patients with endometrial cancer. Methods: From 8 institutions, the medical records of 397 patients who underwent pelvic and para-aortic lymphadenectomy as a surgical staging procedure were retrospectively reviewed. A multivariate logistic regression model was created and internally validated by rigorous bootstrap resampling methods. Finally, the model was transformed into a user-friendly Web-based nomogram (http://www.kgog.org/ nomogram/empa001.html). Results: The rate of para-aortic nodal metastasis was 14.4% (57/397 patients). Using a stepwisevariable selection, 4 variables including deepmyometrial invasion, non-endometrioid subtype, lymphovascular space invasion, and log-transformed CA-125 levels were finally adopted. After 1000 repetitions of bootstrapping, all of these 4 variables retained a significant association with para-aortic nodal metastasis in the multivariate analysis - deep myometrial invasion (P = 0.001), nonYendometrioid histologic subtype (P = 0.034), lymphovascular space invasion (P = 0.003), and log-transformed serum CA-125 levels (P = 0.004). The model showed good discrimination (C statistics = 0.87; 95% confidence interval, 0.82-0.92) and accurate calibration (Hosmer-Lemeshow P = 0.74). Conclusions: This nomogram showed good performance in predicting para-aortic metastasis in patients with endometrial cancer. The tool may be useful in determining the extent of lymphadenectomy after incomplete surgery.

Original languageEnglish
Pages (from-to)513-519
Number of pages7
JournalInternational Journal of Gynecological Cancer
Volume24
Issue number3
DOIs
Publication statusPublished - 2014 Mar

Keywords

  • Endometrial cancer
  • Lymph node
  • Lymphadenectomy
  • Metastasis
  • Para-aortic
  • Staging

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology

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