Nomograms to predict isolated loco-regional or distant recurrence among women with uterine cancer

作者：Kondalsamy Chennakesavan Srinivas; Yu Changhong; Kattan Michael W; Leung Yee; Sykes Peter; Nascimento Marcelo; Nicklin James; Perrin Lewis; Crandon Alex; Chetty Naven; Land Russell; Garrett Andrea; Obermair Andreas^*

来源：Gynecologic Oncology, 2012, 125(3): 520-525.

DOI：10.1016/j.ygyno.2012.02.022

• Uterine cancer
• Recurrence
• Risk-prediction

Objective. While there is ample literature on prognostic factors for uterine cancer, currently there are no means to estimate an individual%26apos;s risk for recurrence or to differentiate the risk of loco-regional recurrence from distant recurrence. We addressed this gap by developing nomograms to individualize the risk of recurrence. %26lt;br%26gt;Methods. A total of 2097 consecutive patients who underwent primary surgery between 1997 and 2007 were included. Sixteen covariates were evaluated for their prognostic significance and modeled using multi-variable competing risks regression to predict three-year outcomes as part of a nomogram. Each covariate in the nomogram is assigned a value, and a sum of these values form the overall risk score from which three-year incidence probabilities can be predicted for each individual. Predictive accuracy was assessed with concordance index and then corrected for optimism. %26lt;br%26gt;Results. The median follow-up time (inter-quartile range, IQR) was 50.0 (28.3-77.5) months and 221 patients developed a recurrence (127 patients with isolated loco-regional recurrence, 94 patients with distant recurrence). The nomograms included the following covariates: age at diagnosis, FIGO stage (2009), grade, lymphovascular invasion, histological type, depth of myometrial invasion, and peritoneal cytology. Concordance indices for isolated loco-regional and distant recurrences were 0.73 and 0.86, respectively. %26lt;br%26gt;Conclusions. Our nomograms quantify an individual patient%26apos;s risk of isolated loco-regional and distant recurrence, using factors that are routinely collected. They may assist clinicians to assess an individual%26apos;s prognosis, individualize treatment and also assist in the risk stratification in prospective randomized clinical trials evaluating the effectiveness of treatments for uterine cancer.

• 出版日期2012-6