Tae-Wook Kong1, Jayoun Kim2, Joo-Hyuk Son1, Seong Woo Kang3, Jiheum Paek1, Mison Chun4, Suk-Joon Chang5, Hee-Sug Ryu1. 1. Gynecologic Cancer Center, Ajou University School of Medicine, Suwon, Republic of Korea; Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Republic of Korea. 2. Research Coordinating Center, Konkuk University Medical Center, Seoul, Republic of Korea. 3. Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Republic of Korea. 4. Gynecologic Cancer Center, Ajou University School of Medicine, Suwon, Republic of Korea; Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea. 5. Gynecologic Cancer Center, Ajou University School of Medicine, Suwon, Republic of Korea; Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Republic of Korea. Electronic address: drchang@ajou.ac.kr.
Abstract
OBJECTIVE: This study aimed to establish a nomogram to predict microscopic parametrial infiltration (PMI) by combining preoperative clinicopathologic factors in FIGO stage IB cervical cancer patients treated by radical hysterectomy (RH). METHODS: We retrospectively analyzed clinicopathologic data of 298 patients with FIGO stage IB cervical cancer treated by RH between February 2000 and March 2015. The nomogram was developed based on multivariate logistic regression analysis of preoperative clinicopathologic data. The accuracy and discriminative ability of the nomogram were evaluated by a concordance index and calibration curve. The low-risk group was predefined as having a predicted probability of PMI <10%. RESULTS: Multivariate analysis identified diameter-based tumor volume and disruption of the cervical stromal ring on magnetic resonance imaging, serum squamous cell carcinoma antigen level, and menopausal status as independent prognostic factors associated with PMI. The concordance index of the nomogram was 0.940 (95% CI, 0.908-0.967), and calibration plots revealed good agreement between the observed probabilities and nomogram-predicted probabilities (Hosmer Lemeshow test, p=0.574). The nomogram classified 200 out of 298 patients (67.1%) as low risk. In the low-risk group, the predicted probability of PMI was 3.5% and the actual PMI rate was 2.5% (5 out of 200). CONCLUSIONS: We developed a preoperative nomogram predicting microscopic PMI in surgically treated FIGO stage IB cervical cancer patients. The probabilities derived from this nomogram may have the potential to provide valuable guidance for physicians regarding the primary management of FIGO stage IB cervical cancer patients.
OBJECTIVE: This study aimed to establish a nomogram to predict microscopic parametrial infiltration (PMI) by combining preoperative clinicopathologic factors in FIGO stage IB cervical cancerpatients treated by radical hysterectomy (RH). METHODS: We retrospectively analyzed clinicopathologic data of 298 patients with FIGO stage IB cervical cancer treated by RH between February 2000 and March 2015. The nomogram was developed based on multivariate logistic regression analysis of preoperative clinicopathologic data. The accuracy and discriminative ability of the nomogram were evaluated by a concordance index and calibration curve. The low-risk group was predefined as having a predicted probability of PMI <10%. RESULTS: Multivariate analysis identified diameter-based tumor volume and disruption of the cervical stromal ring on magnetic resonance imaging, serum squamous cell carcinoma antigen level, and menopausal status as independent prognostic factors associated with PMI. The concordance index of the nomogram was 0.940 (95% CI, 0.908-0.967), and calibration plots revealed good agreement between the observed probabilities and nomogram-predicted probabilities (Hosmer Lemeshow test, p=0.574). The nomogram classified 200 out of 298 patients (67.1%) as low risk. In the low-risk group, the predicted probability of PMI was 3.5% and the actual PMI rate was 2.5% (5 out of 200). CONCLUSIONS: We developed a preoperative nomogram predicting microscopic PMI in surgically treated FIGO stage IB cervical cancerpatients. The probabilities derived from this nomogram may have the potential to provide valuable guidance for physicians regarding the primary management of FIGO stage IB cervical cancerpatients.
Authors: Claudia Marchetti; Francesca De Felice; Anna Di Pinto; Alessia Romito; Angela Musella; Innocenza Palaia; Marco Monti; Vincenzo Tombolin; Ludovico Muzii; PierLuigi Benedetti Panici Journal: Cancer Res Treat Date: 2017-07-19 Impact factor: 4.679