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

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Abstract

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.

Original languageEnglish
Article number2917925
JournalBioMed Research International
Volume2017
DOIs
Publication statusPublished - 2017 Jan 1

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Nomograms
Hysterectomy
Uterine Cervical Neoplasms
Dissection
Neoplasm Metastasis
Survival
Disease-Free Survival
Lymph Node Excision
Therapeutics
Histology
Radiotherapy
Tumors
Hazards
Adjuvant Radiotherapy
Irradiation
Proportional Hazards Models
Multivariate Analysis
Lymph Nodes

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)

Cite this

@article{fd59b02b35f249f3b9b03092ea584960,
title = "Validation of Nomograms for Survival and Metastases after Hysterectomy and Adjuvant Therapy in Uterine Cervical Cancer with Risk Factors",
abstract = "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.",
author = "Yoon, {Won Sup} and Dae-Sik Yang and Lee, {Jung Ae} and Lee, {Nam Kwon} and Park, {Young Je} and Kim, {Chul Yong} and Lee, {Nak Woo} and Jin-Hwa Hong and Lee, {Jae Kwan} and Song, {Jae Yun}",
year = "2017",
month = "1",
day = "1",
doi = "10.1155/2017/2917925",
language = "English",
volume = "2017",
journal = "BioMed Research International",
issn = "2314-6133",
publisher = "Hindawi Publishing Corporation",

}

TY - JOUR

T1 - Validation of Nomograms for Survival and Metastases after Hysterectomy and Adjuvant Therapy in Uterine Cervical Cancer with Risk Factors

AU - Yoon, Won Sup

AU - Yang, Dae-Sik

AU - Lee, Jung Ae

AU - Lee, Nam Kwon

AU - Park, Young Je

AU - Kim, Chul Yong

AU - Lee, Nak Woo

AU - Hong, Jin-Hwa

AU - Lee, Jae Kwan

AU - Song, Jae Yun

PY - 2017/1/1

Y1 - 2017/1/1

N2 - 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.

AB - 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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DO - 10.1155/2017/2917925

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