Individualized Prediction of Overall Survival After Postoperative Radiation Therapy in Patients With Early-Stage Cervical Cancer: A Korean Radiation Oncology Group Study (KROG 13-03)
Individualized Prediction of Overall Survival After Postoperative Radiation Therapy in Patients With Early-Stage Cervical Cancer: A Korean Radiation Oncology Group Study (KROG 13-03)
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DOI：
10.1016/j.ijrobp.2013.07.020
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发表时间：
2013-11-15
影响因子：
7
通讯作者：
Kim, Joo-Young
中科院分区：
文献类型：
--
作者：
Lee, Hyun Jin;Han, Seungbong;Kim, Joo-Young
目的：诺模图是一种预测统计模型，它生成临床事件(如死亡或复发)的连续概率。本研究的目的是构建一个预测IB-IIA期宫颈癌术后放疗后5年总生存率的诺模图。方法与材料：回顾1990年至2011年在10家参与医院治疗的1702例早期宫颈癌患者的临床资料，建立基于COX比例风险模型的预测诺模图。人口统计、临床和病理变量被纳入并分析，以形成诺模图。结果：存活患者的中位随访期为75.6个月，5年总生存概率为87.1%。最终的模型是使用以下变量构建的：年龄、阳性盆腔淋巴结数、宫旁侵犯、淋巴管侵犯和同期化疗的使用。诺模图预测5年总生存率的c指数为0.69，优于国际妇产科联合会(FIGO)分期系统的预测能力(c指数0.54)。结论：在一项大型多中心研究的基础上，建立了一个能提供准确水平预测和鉴别的生存预测诺模图。对于个别患者的预后咨询，该模型可能比FIGO分期系统更有用。(C)2013年爱思唯尔公司。
Purpose: A nomogram is a predictive statistical model that generates the continuous probability of a clinical event such as death or recurrence. The aim of the study was to construct a nomogram to predict 5-year overall survival after postoperative radiation therapy for stage IB to IIA cervical cancer.Methods and Materials: The clinical data from 1702 patients with early-stage cervical cancer, treated at 10 participating hospitals from 1990 to 2011, were reviewed to develop a prediction nomogram based on the Cox proportional hazards model. Demographic, clinical, and pathologic variables were included and analyzed to formulate the nomogram. The discrimination and calibration power of the model was measured using a concordance index (c-index) and calibration curve.Results: The median follow-up period for surviving patients was 75.6 months, and the 5-year overall survival probability was 87.1%. The final model was constructed using the following variables: age, number of positive pelvic lymph nodes, parametrial invasion, lymphovascular invasion, and the use of concurrent chemotherapy. The nomogram predicted the 5-year overall survival with a c-index of 0.69, which was superior to the predictive power of the International Federation of Gynecology and Obstetrics (FIGO) staging system (c-index of 0.54).Conclusions: A survival-predicting nomogram that offers an accurate level of prediction and discrimination was developed based on a large multi-center study. The model may be more useful than the FIGO staging system for counseling individual patients regarding prognosis. (C) 2013 Elsevier Inc.