How low is low enough? Evaluation of various risk-assessment models for lymph node metastasis in endometrial cancer: a Korean multicenter study.
How low is low enough? Evaluation of various risk-assessment models for lymph node metastasis in endometrial cancer: a Korean multicenter study.
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DOI：
10.3802/jgo.2012.23.4.251
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发表时间：
2012-10
影响因子：
3.9
通讯作者：
Kim KT
中科院分区：
文献类型：
--
作者：
Kang S;Lee JM;Lee JK;Kim JW;Cho CH;Kim SM;Park SY;Park CY;Kim KT
这项研究的目的是通过评估著名的手术病理模型的性能，为未来预测子宫内膜癌淋巴转移的模型确定一个标准。通过对947例子宫内膜癌患者行淋巴结清扫手术的病历资料进行回顾性分析，对现有模型预测子宫内膜癌转移的效果进行了评价。我们评估了三个模型：1)妇科肿瘤组(GOG)初步研究的修正模型；2)GOG-33数据的模型；以及3)Mayo临床数据的模型。三种模型的阴性预测值在97.1%~97.4%之间。使用贝叶斯定理，当假设有10%的淋巴结转移时，这可以转化为测试后负概率的2%。此外，尽管这些模型的阴性预测值相似，但被归类为低风险的比例在不同研究之间有显著差异(分别为56.4%、44.8%和30.5%；p<；0.001)。目前的研究表明，假阴性率在2%或更低时，应该作为确定术前或术中预测低风险淋巴结转移的模型的临床有效性的目标。
The aim of this study was to identify a standard for the evaluation of future models for prediction of lymph node metastasis in endometrial cancer through estimation of performance of well-known surgicopathological models. Using the medical records of 947 patients with endometrial cancer who underwent surgical management with lymphadenectomy, we retrospectively assessed the predictive performances of nodal metastasis of currently available models. We evaluated three models included: 1) a model modified from the Gynecologic Oncology Group (GOG) pilot study; 2) one from the GOG-33 data; and 3) one from Mayo Clinic data. The three models showed similar negative predictive values ranging from 97.1% to 97.4%. Using Bayes' theorem, this can be translated into 2% of negative post-test probability when 10% of prevalence of lymph node metastasis was assumed. In addition, although the negative predictive value was similar among these models, the proportion that was classified as low-risk was significantly different between the studies (56.4%, 44.8%, and 30.5%, respectively; p<0.001). The current study suggests that a false negativity of 2% or less should be a goal for determining clinical usefulness of preoperative or intraoperative prediction models for low-risk of nodal metastasis.
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影响因子：
9.3
作者：
Bossuyt, PM;Reitsma, JB;de Vet, HCW
通讯作者：
de Vet, HCW
影响因子：
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作者：
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影响因子：
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通讯作者：
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影响因子：
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作者：
Lee, Taek Sang;Kim, Jae Weon;Ryu, Hee-Sug
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