Hannah S van Meurs1, Ewoud Schuit2, Hugo M Horlings3, Jacobus van der Velden4, Willemien J van Driel5, Ben Willem J Mol6, Gemma G Kenter7, Marrije R Buist8. 1. Department of Obstetrics and Gynecology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: h.s.vanmeurs@amc.nl. 2. Department of Obstetrics and Gynecology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands. Electronic address: e.schuit@umcutrecht.nl. 3. Department of Pathology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: h.m.horlings@amc.nl. 4. Department of Obstetrics and Gynecology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: j.vandervelden@amc.nl. 5. Department of Gynecology, Center for Gynecologic Oncology Amsterdam, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands. Electronic address: w.v.driel@nki.nl. 6. The Robinson Institute, School of Pediatrics and Reproductive Health, University of Adelaide, Level 3 Medical School South Building, Frome Road, SA 5005 Adelaide, Australia. Electronic address: b.w.mol@amc.nl. 7. Department of Obstetrics and Gynecology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: g.g.kenter@amc.nl. 8. Department of Obstetrics and Gynecology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Electronic address: m.r.buist@amc.nl.
Abstract
OBJECTIVE: Models to predict the probability of recurrence free survival exist for various types of malignancies, but a model for recurrence free survival in individuals with an adult granulosa cell tumor (GCT) of the ovary is lacking. We aimed to develop and internally validate such a prognostic model. METHODS: We performed a multicenter retrospective cohort study of patients with a GCT. Demographic, clinical and pathological information were considered as potential predictors. Univariable and multivariable analyses were performed using a Cox proportional hazards model. Using backward stepwise selection we identified the combination of predictors that best predicted recurrence free survival. Discrimination (c-statistic) and calibration were used to assess model performance. The model was internally validated using bootstrapping techniques to correct for overfitting. To increase clinical applicability of the model we developed a nomogram to allow individual prediction of recurrence free survival. RESULTS: We identified 127 patients with a GCT (median follow-up time was 131 months (IQR 70-215)). Recurrence of GCT occurred in 81 out of 127 patients (64%). The following four variables jointly best predicted recurrence free survival; clinical stage, Body Mass Index (BMI), tumor diameter and mitotic index. The model had a c-statistic of 0.73 (95% CI 0.66-0.80) and showed accurate calibration. CONCLUSIONS: Recurrence free survival in patients with an adult GCT of the ovary can be accurately predicted by a combination of BMI, clinical stage, tumor diameter and mitotic index. The introduced nomogram could facilitate in counseling patients and may help to guide patients and caregivers in joint decisions on post-treatment surveillance.
OBJECTIVE: Models to predict the probability of recurrence free survival exist for various types of malignancies, but a model for recurrence free survival in individuals with an adult granulosa cell tumor (GCT) of the ovary is lacking. We aimed to develop and internally validate such a prognostic model. METHODS: We performed a multicenter retrospective cohort study of patients with a GCT. Demographic, clinical and pathological information were considered as potential predictors. Univariable and multivariable analyses were performed using a Cox proportional hazards model. Using backward stepwise selection we identified the combination of predictors that best predicted recurrence free survival. Discrimination (c-statistic) and calibration were used to assess model performance. The model was internally validated using bootstrapping techniques to correct for overfitting. To increase clinical applicability of the model we developed a nomogram to allow individual prediction of recurrence free survival. RESULTS: We identified 127 patients with a GCT (median follow-up time was 131 months (IQR 70-215)). Recurrence of GCT occurred in 81 out of 127 patients (64%). The following four variables jointly best predicted recurrence free survival; clinical stage, Body Mass Index (BMI), tumor diameter and mitotic index. The model had a c-statistic of 0.73 (95% CI 0.66-0.80) and showed accurate calibration. CONCLUSIONS: Recurrence free survival in patients with an adult GCT of the ovary can be accurately predicted by a combination of BMI, clinical stage, tumor diameter and mitotic index. The introduced nomogram could facilitate in counseling patients and may help to guide patients and caregivers in joint decisions on post-treatment surveillance.
Authors: Stine E Weis-Banke; Mads Lerdrup; Daniela Kleine-Kohlbrecher; Faizaan Mohammad; Simone Sidoli; Ole N Jensen; Toshihiko Yanase; Tomoko Nakamura; Akira Iwase; Anthe Stylianou; Nadeem R Abu-Rustum; Carol Aghajanian; Robert Soslow; Arnaud Da Cruz Paula; Richard P Koche; Britta Weigelt; Jesper Christensen; Kristian Helin; Paul A C Cloos Journal: Cancer Res Date: 2020-07-08 Impact factor: 12.701
Authors: Melissa K McConechy; Anniina Färkkilä; Hugo M Horlings; Aline Talhouk; Leila Unkila-Kallio; Hannah S van Meurs; Winnie Yang; Nirit Rozenberg; Noora Andersson; Katharina Zaby; Saara Bryk; Ralf Bützow; Johannes B G Halfwerk; Gerrit K J Hooijer; Marc J van de Vijver; Marrije R Buist; Gemma G Kenter; Sara Y Brucker; Bernhard Krämer; Annette Staebler; Maaike C G Bleeker; Markku Heikinheimo; Stefan Kommoss; C Blake Gilks; Mikko Anttonen; David G Huntsman Journal: J Natl Cancer Inst Date: 2016-06-13 Impact factor: 13.506
Authors: Joline F Roze; Hannah S van Meurs; Glen R Monroe; Wouter B Veldhuis; Luc R C W van Lonkhuijzen; Roel J Bennink; Jolijn W Groeneweg; Petronella O Witteveen; Geertruida N Jonges; Ronald P Zweemer; Arthur J A T Braat Journal: Oncotarget Date: 2021-03-30