Nomogram for Predicting Recurrence-Free Survival in Chinese Women with Endometrial Cancer after Initial Therapy: External Validation
Nomogram for Predicting Recurrence-Free Survival in Chinese Women with Endometrial Cancer after Initial Therapy: External Validation
复制标题
预测中国子宫内膜癌女性初次治疗后无复发生存率的列线图：外部验证
DOI：
10.1155/2020/2363545
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发表时间：
2020-05-29
影响因子：
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通讯作者：
Wang, Jianliu
中科院分区：
文献类型：
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作者：
Cheng, Yuan;Dong, Yangyang;Wang, Jianliu
本研究旨在开发一种可用的子宫内膜癌（EC）无复发生存（RFS）模型，以进行准确和个体化的预后评估。对 2006 年至 2016 年期间 520 名接受初始手术治疗的 EC 女性的训练队列和由 445 名符合条件的 EC 患者组成的外部验证队列进行了回顾性分析。使用多变量 Cox 比例风险回归模型来开发列线图来预测复发。计算一致性指数（C 指数）和受试者工作特征曲线下面积（AUC）以确定 RFS 预后评分系统的区分度。生成校准图来检查预测列线图的性能特征。回归分析显示，国际妇产科联合会 (FIGO) 分期先进、组织学 3 级、原发肿瘤直径≥2cm 和腹膜细胞学阳性是训练集中 EC 中 RFS 的独立预后因素。列线图根据这四个变量估计了 RFS，其 C 指数为 0.860，优于训练组中 FigO 阶段（2009 年标准）的 0.809（P=0.034）。令人鼓舞的是，在验证集中观察到了一致的结果，列线图的 C 指数为 0.875，FIGO 分期的 C 指数为 0.833（P=0.0137）。此外，预测 3 年和 5 年 RFS 的列线图校准与实际生存结果密切相关。总之，本研究开发了一个可用的列线图，具有有效的外部验证和相对明显的区分度和一致性，用于准确评估中国 EC 女性的 3 年和 5 年 RFS。
This study aimed at developing an available recurrence-free survival (RFS) model of endometrial cancer (EC) for accurate and individualized prognosis assessment. A training cohort of 520 women with EC who underwent initial surgical treatment and an external validation cohort of 445 eligible EC patients from 2006 to 2016 were analyzed retrospectively. Multivariable Cox proportional hazards regression models were used to develop nomograms for predicting recurrence. The concordance index (C-index) and the area under the receiver operating characteristic curve (AUC) were calculated to determine the discrimination of RFS prognostic scoring systems. Calibration plots were generated to examine the performance characteristics of the predictive nomograms. Regression analysis revealed that an advanced International Federation of Gynecology and Obstetrics (FIGO) stage, histological grade 3, primary tumor diameter ≥2 cm, and positive peritoneal cytology were independent prognostic factors for RFS in EC in the training set. The nomograms estimated RFS according to these four variables, with a C-index of 0.860, which was superior to that of FIGO stage (2009 criteria), at 0.809 (P=0.034), in the training cohort. Encouragingly, consistent results were observed in the validation set, with a C-index of 0.875 for the nomogram and a C-index of 0.833 for the FIGO staging (P=0.0137). Furthermore, the calibrations of the nomograms predicting 3- and 5-year RFS strongly corresponded to the actual survival outcome. In conclusion, this study developed an available nomogram with effective external validation and relatively appreciable discrimination and conformity for the accurate assessment of 3- and 5-year RFS in Chinese women with EC.