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Radiother Oncol. 2014 Jun;111(3):437-41. doi: 10.1016/j.radonc.2014.03.025. Epub 2014 Jun 5.

A nomogram predicting the risks of distant metastasis following postoperative radiotherapy for uterine cervical carcinoma: a Korean radiation oncology group study (KROG 12-08).

Author information

1
Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Republic of Korea.
2
Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Republic of Korea. Electronic address: ysk@amc.seoul.kr.
3
Seoul National University Hospital, Republic of Korea.
4
Samsung Medical Center, Sungkyunkwan University Scholl of Medicine, Seoul, Republic of Korea.
5
Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea.
6
Cheil General Hospital and Women's Healthcare Center, Kwandong University, College of Medicine, Seoul, Republic of Korea.
7
Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Republic of Korea.
8
The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea.
9
Korea University Ansan Hospital, Republic of Korea.
10
Chung-Ang University Hospital, Seoul, Republic of Korea.
11
Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.

Abstract

PURPOSE:

To develop a nomogram predicting the risks of distant metastasis following postoperative adjuvant radiation therapy for early stage cervical cancer.

MATERIALS AND METHODS:

We reviewed the medical records of 1069 patients from ten participating institutions. Patients were divided into two cohorts: a training set (n=748) and a validation set (n=321). The demographic, clinical, and pathological variables were included in the univariate Cox proportional hazards analysis. Clinically established and statistically significant prognostic variables were utilized to develop a nomogram.

RESULTS:

The model was constructed using four variables: histologic type, pelvic lymph node involvement, depth of stromal invasion, and parametrial invasion. This model demonstrated good calibration and discrimination, with an internally validated concordance index of 0.71 and an externally validated c-index of 0.65. Compared to FIGO staging, which showed a broad range in terms of distant metastasis, the developed nomogram can accurately predict individualized risks based on individual risk factors.

CONCLUSIONS:

The devised model offers a significantly accurate level of prediction and discrimination. In clinical practice it could be useful for counseling patients and selecting the patient group who could benefit from more intensive/further chemotherapy, once validated in a prospective patient cohort.

KEYWORDS:

Adjuvant radiotherapy; Nomogram; Uterine cervical cancer

PMID:
24909094
DOI:
10.1016/j.radonc.2014.03.025
[Indexed for MEDLINE]

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