Construction and validation of a prognostic model for stage IIIC endometrial cancer patients after surgery

Yang, Xilin; Huang, Hong; Kou, Lingna; Lai, Hua; Xiao-pin, Chen; Wu, Dehua

doi:10.1016/j.ejso.2021.12.462

Cited by 5 publications

(10 citation statements)

References 25 publications

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“…We chose age, race, grade, histology, T stage, tumor size, and LODDS from the univariate Cox analysis (all p < 0.05). Surprisingly or not, 09 FIGO stage was not able to discern the patients with optimal overall survival from those who had not ( p = 0.062), which was in accordance with the previous studies ( 9 , 13 , 14 , 16 , 18 ). Multivariate analysis was sequentially performed to identify the age, grade, T stage, tumor size, and LODDS as the independent risk factors for the survival outcomes in stage IIIC EC patients with ART alone ( Table 2 ).…”

Section: Resultssupporting

confidence: 89%

“…However, none of the previous studies had evaluated the predictive power of the combination of these indices in stage IIIC EC patients with ART alone, let alone guide the clinical decision-making using this combination. As one nascent calculation method integrating pivotal clinical-pathological risk factors to predict oncological outcomes, nomogram has been widely used in EC patients (14,(30)(31)(32). however, few of these had focused exclusively on stage IIIC EC patients (14).…”

Section: Discussionmentioning

confidence: 99%

“…As one nascent calculation method integrating pivotal clinical-pathological risk factors to predict oncological outcomes, nomogram has been widely used in EC patients (14,(30)(31)(32). however, few of these had focused exclusively on stage IIIC EC patients (14). Actually, we have developed a pretty solid prediction model for post-operative stage IIIC EC patients receiving different kinds of adjuvant treatment in previous research (14), which was able to individually predict the oncological outcomes for stage IIIC EC regardless of the adjuvant treatment modality, but it was not suitable for adjuvant treatment decision-making.…”

Section: Discussionmentioning

confidence: 99%

“…As one nascent calculation method integrating pivotal clinical–pathological risk factors to predict oncological outcomes, nomogram has been widely used in EC patients ( 14 , 30 – 32 ). however, few of these had focused exclusively on stage IIIC EC patients ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

“…It is noteworthy that rare pathological histology type was not included in this study, and we presented the histology type as type I (endometrioid cancer and adenocarcinoma) and type II consisting of serous cancer, carcinosarcoma, and clear cell cancer. The log odds of positive lymph nodes (LODDS), defined as log e [(number of positive LN + 0.5)/(number of negative LN + 0.5)], was calculated to represent the LN status given that our previous studies have demonstrated that LODDS was the optimal LN index to predict the survival probability for EC patients with LN metastases ( 13 , 14 ). X-tile software (version 3.6.1; Yale University, New Haven, CT, USA) was used to identify the best cutoff values for continuous variables including age, tumor size, and LODDS given the inconsistency of these cutoff values from previous research ( 8 , 15 – 18 ).…”

Section: Methodsmentioning

confidence: 99%

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Prognostic model for the exemption of adjuvant chemotherapy in stage IIIC endometrial cancer patients

Yang¹,

Yang²,

Kou³

et al. 2022

Front. Endocrinol.

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BackgroundThis study aimed to develop a nomogram to predict the survival for stage IIIC endometrial cancer (EC) patients with adjuvant radiotherapy (ART) alone and personalize recommendations for the following adjuvant chemotherapy (ACT).MethodsIn total, 746 stage IIIC EC patients with ART alone were selected from the Surveillance, Epidemiology, and End Results (SEER) registry. Cox regression analysis was performed to identify independent risk factors. A nomogram was developed accordingly, and the area under the receiver operating characteristic curve (AUC) and C-index were implemented to assess the predictive power. The patients were divided into different risk strata based on the total points derived from the nomogram, and survival probability was compared between each risk stratus and another SEER-based cohort of stage IIIC EC patients receiving ART+ACT (cohort ART+ACT).ResultsFive independent predictors were included in the model, which had favorable discriminative power both in the training (C-index: 0.732; 95% CI: 0.704–0.760) and validation cohorts (C-index: 0.731; 95% CI: 0.709–0.753). The patients were divided into three risk strata (low risk <135, 135 ≤ middle risk ≤205, and high risk >205), where low-risk patients had survival advantages over patients from cohort ART+ACT (HR: 0.45, 95% CI: 0.33–0.61, P < 0.001). However, the middle- and high-risk patients were inferior to patients from cohort ART+ACT in survival (P < 0.001).ConclusionA nomogram was developed to exclusively predict the survival for stage IIIC EC patients with ART alone, based on which the low-risk patients might be perfect candidates to omit the following ACT. However, the middle- and high-risk patients would benefit from the following ACT.

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Section: Resultssupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Prognostic model for the exemption of adjuvant chemotherapy in stage IIIC endometrial cancer patients

Yang¹,

Yang²,

Kou³

et al. 2022

Front. Endocrinol.

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Validating the 2023 FIGO staging system: A nomogram for endometrioid endometrial cancer and adenocarcinoma

Feng,

Miao,

et al. 2024

Cancer Medicine

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BackgroundTo find the factors impacting overall survival (OS) prognosis in patients with endometrioid endometrial carcinoma (EEC) and adenocarcinoma and to establish a nomogram model to validate the 2023 International Federation of Obstetrics and Gynecology (FIGO) staging system for endometrial cancer.MethodsData were obtained from the Surveillance, Epidemiology, and End Results (SEER) training cohort. An independent validation cohort was obtained from the First Affiliated Hospital of Anhui Medical University between 2008 and 2023. Cox regression analysis identified independent prognostic factors for OS in EEC and adenocarcinoma patients. A nomogram predicting OS was developed and validated utilizing the C‐index, calibration curves, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA). The relationship between the tumor grade and prognosis of EEC and adenocarcinoma was quantified using net reclassification improvement (NRI), propensity score matching (PSM), and Kaplan–Meier curves.ResultsCox regression analysis identified age, race, marital status, tumor grade, tumor stage, tumor size, and chemotherapy as independent prognostic factors for OS. A nomogram for predicting OS was developed based on these factors. The C‐indexes for the OS nomogram was 0.743 and 0.720 for the SEER training set and external validation set, respectively. The area under the ROC (AUC) for the OS nomogram was 0.755, 0.757, and 0.741 for the SEER data subsets and 0.844, 0.719, and 0.743 for the external validation subsets. Calibration plots showed high concordance between the nomogram‐predicted and observed OS. DCA also demonstrated the clinical utility of the OS nomogram. NRI, PSM, and survival analyses revealed that tumor grade was the most important histopathological factor for EEC and adenocarcinoma prognosis.ConclusionSeven independent prognostic variables for the OS of patients with EEC and adenocarcinoma were identified. The established OS nomogram has good predictive ability and clinical utility and validates the 2023 endometrial cancer FIGO staging system.

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A population-based risk scoring system to individualize adjuvant treatment for stage IIIC endometrial cancer patients after surgery

Yang

Zhang

Kou

et al. 2023

European Journal of Surgical Oncology

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Construction and validation of a prognostic model for stage IIIC endometrial cancer patients after surgery

Cited by 5 publications

References 25 publications

Prognostic model for the exemption of adjuvant chemotherapy in stage IIIC endometrial cancer patients

Prognostic model for the exemption of adjuvant chemotherapy in stage IIIC endometrial cancer patients

Validating the 2023 FIGO staging system: A nomogram for endometrioid endometrial cancer and adenocarcinoma

A population-based risk scoring system to individualize adjuvant treatment for stage IIIC endometrial cancer patients after surgery

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