Individualized prediction of overall survival after postoperative radiation therapy in patients with early-stage cervical cancer: A Korean radiation oncology group study (KROG 13-03)

Hyun Jin Lee, Seungbong Han, Young Seok Kim, Joo Hyun Nam, Hak Jae Kim, Jae Weon Kim, Won Park, Byoung Gie Kim, Jin Hee Kim, Soon Do Cha, 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

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7 Citations (Scopus)

Abstract

Purpose: A nomogram is a predictive statistical model that generates the continuous probability of a clinical event such as death or recurrence. The aim of the study was to construct a nomogram to predict 5-year overall survival after postoperative radiation therapy for stage IB to IIA cervical cancer. Methods and Materials: The clinical data from 1702 patients with early-stage cervical cancer, treated at 10 participating hospitals from 1990 to 2011, were reviewed to develop a prediction nomogram based on the Cox proportional hazards model. Demographic, clinical, and pathologic variables were included and analyzed to formulate the nomogram. The discrimination and calibration power of the model was measured using a concordance index (c-index) and calibration curve. Results: The median follow-up period for surviving patients was 75.6 months, and the 5-year overall survival probability was 87.1%. The final model was constructed using the following variables: age, number of positive pelvic lymph nodes, parametrial invasion, lymphovascular invasion, and the use of concurrent chemotherapy. The nomogram predicted the 5-year overall survival with a c-index of 0.69, which was superior to the predictive power of the International Federation of Gynecology and Obstetrics (FIGO) staging system (c-index of 0.54). Conclusions: A survival-predicting nomogram that offers an accurate level of prediction and discrimination was developed based on a large multi-center study. The model may be more useful than the FIGO staging system for counseling individual patients regarding prognosis.

Original languageEnglish
Pages (from-to)659-664
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume87
Issue number4
DOIs
Publication statusPublished - 2013 Nov 15

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ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Lee, H. J., Han, S., Kim, Y. S., Nam, J. H., Kim, H. J., Kim, J. W., Park, W., Kim, B. G., Kim, J. H., Cha, S. D., Kim, J., Lee, K. H., Yoon, M. S., Kim, S. M., Kim, J. Y., Yoon, W. S., Lee, N. W., Choi, J. H., Park, S. Y., & Kim, J. Y. (2013). Individualized prediction of overall survival after postoperative radiation therapy in patients with early-stage cervical cancer: A Korean radiation oncology group study (KROG 13-03). International Journal of Radiation Oncology Biology Physics, 87(4), 659-664. https://doi.org/10.1016/j.ijrobp.2013.07.020