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

Yang, Xilin; Yang, Feng-Leng; Kou, Lingna; Wu, Dehua; Xie, Conghua

doi:10.3389/fendo.2022.989063

Cited by 2 publications

(2 citation statements)

References 36 publications

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“…Tumor size made quite a large contribution to the nomogram output, similar to that of stage. Tumor size has a significant impact on the prognosis of patients with endometrial cancer, 38 , 39 another finding was validated by our nomogram model. The tumor size can be measured more accurately through preoperative imaging, which is clinically relevant for the selection of surgical procedures and adjuvant treatments for endometrial cancer.…”

Section: Discussionsupporting

confidence: 62%

“…Tumor size made quite a large contribution to the nomogram output, similar to that of stage. Tumor size has a significant impact on the prognosis of patients with endometrial cancer, 38,39 more accurately through preoperative imaging, which is clinically relevant for the selection of surgical procedures and adjuvant treatments for endometrial cancer. 40 In the future, with more data validation, tumor size could serve as a clinical indicator for substaging within the FIGO staging system to further guide clinical treatment.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 62%

“…Tumor size made quite a large contribution to the nomogram output, similar to that of stage. Tumor size has a significant impact on the prognosis of patients with endometrial cancer, 38,39 more accurately through preoperative imaging, which is clinically relevant for the selection of surgical procedures and adjuvant treatments for endometrial cancer. 40 In the future, with more data validation, tumor size could serve as a clinical indicator for substaging within the FIGO staging system to further guide clinical treatment.…”

Section: Discussionmentioning

confidence: 99%

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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Guiding adjuvant radiotherapy in stage III endometrial cancer: a prognostic model based on SEER

Li,

Han,

Chen

et al. 2024

Front. Oncol.

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BackgroundThe effect of overall survival (OS) with adjuvant radiotherapy in stage III endometrial cancer (EC) remains controversial, and the adverse invents were unignorable.MethodsA total of 4,064 stage III EC patients who underwent adjuvant chemotherapy post-operatively were selected from Surveillance, Epidemiology, and End Results (SEER) Program. Independent risk factors were identified through Cox regression models. A nomogram was developed accordingly to predict OS. The concordance index (C-index), calibration, and Receiver Operating Characteristic (ROC) curves were applied to assess the model. Patients were divided into the low- and high-risk groups based on the optimal risk cutoff. Stratified analysis was conducted by radiation in both groups, and interactions between radiation and the risk groups were conducted to explore if any benefit less from adjuvant radiotherapy.ResultsA total of five candidate factors were identified from the model showing good calibration and consistency discriminative power in the training (C-index: 0.73; 95% CI: 0.70–0.75), testing (C-index: 0.73; 95% CI: 0.69–0.77), and external validation cohorts (C-index: 0.88, 95% CI, 0.78–0.97). Patients were categorized into the low- and high-risk groups based on the optimal risk cutoff of 2.1048630. The women in the high-risk group experience significantly less (42% vs. 63% reduction) or none (0 vs. 63%) benefit (p-interaction = 0.049 vs. 0.016 in training and testing cohorts, respectively).ConclusionA nomogram incorporating five variables was established to predict OS in stage III EC patients with adjuvant chemotherapy. The high-risk groups benefit less or none from adjuvant radiotherapy, which may serve as a useful reference for better guidance of radiotherapy in stage III EC patients.

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

Cited by 2 publications

References 36 publications

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

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

Guiding adjuvant radiotherapy in stage III endometrial cancer: a prognostic model based on SEER

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