Peter G Rose1, James Java2, Charles W Whitney2, Frederick B Stehman2, Rachelle Lanciano2, Gillian M Thomas2, Paul A DiSilvestro2. 1. Peter G. Rose, Cleveland Clinic Foundation and Case Western Reserve University, Cleveland, OH; James Java, Gynecologic Oncology Group Statistical and Data Center, Roswell Park Cancer Institute, Buffalo, NY; Charles W. Whitney, Christiana Gynecologic Oncology, Apex Medical Center, Newark, DE; Frederick B. Stehman, Mel and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN; Rachelle Lanciano, Delaware County Regional Cancer Center, Drexel Hill, PA; Gillian M. Thomas, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada; and Paul A. DiSilvestro, Women and Infants Hospital, Brown University, Providence, RI. rosep@ccf.org. 2. Peter G. Rose, Cleveland Clinic Foundation and Case Western Reserve University, Cleveland, OH; James Java, Gynecologic Oncology Group Statistical and Data Center, Roswell Park Cancer Institute, Buffalo, NY; Charles W. Whitney, Christiana Gynecologic Oncology, Apex Medical Center, Newark, DE; Frederick B. Stehman, Mel and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN; Rachelle Lanciano, Delaware County Regional Cancer Center, Drexel Hill, PA; Gillian M. Thomas, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada; and Paul A. DiSilvestro, Women and Infants Hospital, Brown University, Providence, RI.
Abstract
PURPOSE: To evaluate the prognostic factors in locally advanced cervical cancer limited to the pelvis and develop nomograms for 2-year progression-free survival (PFS), 5-year overall survival (OS), and pelvic recurrence. PATIENTS AND METHODS: We retrospectively reviewed 2,042 patients with locally advanced cervical carcinoma enrolled onto Gynecologic Oncology Group clinical trials of concurrent cisplatin-based chemotherapy and radiotherapy. Nomograms for 2-year PFS, five-year OS, and pelvic recurrence were created as visualizations of Cox proportional hazards regression models. The models were validated by bootstrap-corrected, relatively unbiased estimates of discrimination and calibration. RESULTS: Multivariable analysis identified prognostic factors including histology, race/ethnicity, performance status, tumor size, International Federation of Gynecology and Obstetrics stage, tumor grade, pelvic node status, and treatment with concurrent cisplatin-based chemotherapy. PFS, OS, and pelvic recurrence nomograms had bootstrap-corrected concordance indices of 0.62, 0.64, and 0.73, respectively, and were well calibrated. CONCLUSION: Prognostic factors were used to develop nomograms for 2-year PFS, 5-year OS, and pelvic recurrence for locally advanced cervical cancer clinically limited to the pelvis treated with concurrent cisplatin-based chemotherapy and radiotherapy. These nomograms can be used to better estimate individual and collective outcomes.
PURPOSE: To evaluate the prognostic factors in locally advanced cervical cancer limited to the pelvis and develop nomograms for 2-year progression-free survival (PFS), 5-year overall survival (OS), and pelvic recurrence. PATIENTS AND METHODS: We retrospectively reviewed 2,042 patients with locally advanced cervical carcinoma enrolled onto Gynecologic Oncology Group clinical trials of concurrent cisplatin-based chemotherapy and radiotherapy. Nomograms for 2-year PFS, five-year OS, and pelvic recurrence were created as visualizations of Cox proportional hazards regression models. The models were validated by bootstrap-corrected, relatively unbiased estimates of discrimination and calibration. RESULTS: Multivariable analysis identified prognostic factors including histology, race/ethnicity, performance status, tumor size, International Federation of Gynecology and Obstetrics stage, tumor grade, pelvic node status, and treatment with concurrent cisplatin-based chemotherapy. PFS, OS, and pelvic recurrence nomograms had bootstrap-corrected concordance indices of 0.62, 0.64, and 0.73, respectively, and were well calibrated. CONCLUSION: Prognostic factors were used to develop nomograms for 2-year PFS, 5-year OS, and pelvic recurrence for locally advanced cervical cancer clinically limited to the pelvis treated with concurrent cisplatin-based chemotherapy and radiotherapy. These nomograms can be used to better estimate individual and collective outcomes.
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