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)
- 김진희; 차순도
- Alternative Author(s)
- Kim, Jin Hee; Cha, Soon Do
- Publication Year
- 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
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
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.
2013 Elsevier Inc.
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