Postoperative Nomogram Predicting Risk of Recurrence After Radical Hysterectomy for Early-Stage Cervical Cancer. Issue 9 (1st November 2010)

• Record Type: Journal Article
• Authors: Kim, Mi-Kyung; Jo, Hoenil; Kong, Hyoun-Joong; Kim, Hee Chan; Kim, Jae Weon; Kim, Yong-Man; Song, Yong-Sang; Kang, Soon-Beom; Mok, Jung-Eun; Lee, Hyo Pyo
• Is Part Of: International journal of gynecological cancer. Volume 20:Issue 9(2010)
• Page Start: 1581
• Page End: 1586
• Publication Date: 2010-11-01
• Subjects: Cervical cancer -- Nomogram -- Prognosis -- Radical hysterectomy; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1111/IGC.0b013e3181f7b353
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objective: The aim of this study was to develop a nomogram for predicting the 5-year disease-free survival (DFS) after radical hysterectomy for early-stage cervical cancer. Patients and Methods: An institutional database of 275 consecutive patients treated at Seoul National University Hospital for stage I to stage IIA cervical cancer was used to develop a nomogram based on Cox proportional hazards regression model. The developed nomogram was internally validated with bootstrapping, and performance was assessed by concordance index and a calibration curve. External validation was also performed using an independent data set of patients from Asan Medical Center. Results: From Cox regression analysis, disease stage, number of positive lymph nodes, parametrial involvement, and depth of invasion were identified as independent risk factors for disease recurrence ( P < 0.05). The nomogram incorporating these factors appeared to be accurate and predicted the outcomes better than the International Federation of Gynecology and Obstetrics stage alone (concordance index, 0.858 compared with 0.719; P = 0.001). When applied to a separate validation set, the nomogram also showed similar predictive accuracy (concordance index, 0.879). Conclusion: We have developed a nomogram that can predict the recurrence risk in patients with early-stage cervical cancer after surgery, which was internally and externally validated.