Predicting poor prognosis recurrence in women with endometrial cancer : a nomogram developed by the FRANCOGYN study group
Menée en France à partir de données portant sur 574 patientes atteintes d'un cancer de l'endomètre traité par chirurgie entre 2001 et 2013, puis validée à partir de données portant sur 287 patientes complémentaires, cette étude multicentrique évalue la performance d'un nomogramme, basé sur six critères clinico-pathologiques (âge, stade selon les critères FIGO, type histologique, ...), pour prédire le risque de récidive associée à un mauvais pronostic
Background : The purpose of this study was to develop a nomogram to predict ‘poor prognosis recurrence’ (PPR) in women treated for endometrial cancer (EC).
Methods : The data of 861 women who received primary surgical treatment between January 2001 and December 2013 were abstracted from a prospective multicenter database. Data were randomly split into two sets: training and validation with a predefined 2/3 ratio. A Cox proportional hazards multivariate model of selected prognostic features was performed in the training cohort (n=574) to develop a nomogram predicting PPRs. The nomogram was validated in the validation cohort of 287 patients.
Results : In the training cohort, 82 (14.3%) developed subsequent PPR. Age, histologic type and grade, lymphovascular space invasion status, FIGO stage, and nodal staging (SLN±pelvic and/or para-aortic lymphadenectomy) were independently associated with subsequent PPR. The nomogram showed an area under the receiver operating characteristic curve (AUC) of 0.82 (95% confidence interval (CI), 0.73–0.89) in the training set. The validation set showed a good discrimination with an AUC of 0.75 (95% CI, 0.65–0.83).
Conclusions : We have developed a robust tool that is able to predict subsequent PPRs in women with FIGO I–III EC.
British Journal of Cancer , résumé, 2015