期刊
FRONTIERS IN ONCOLOGY
卷 12, 期 -, 页码 -出版社
FRONTIERS MEDIA SA
DOI: 10.3389/fonc.2022.857375
关键词
cervical cancer; lymph node metastasis; nomogram; overall survival; cancer-specific survival
类别
资金
- Tianjin Health Science and Technology Project, Science and Technology Talent Cultivation Project [KJ20110]
- Tianjin Health Science and Technology Project, Youth Talent Project [TJWJ2021QN023]
- Tianjin Key Medical Discipline (Specialty) Construction Project
The study aimed to establish and validate individualized nomograms for predicting overall survival and cancer-specific survival in cervical cancer patients with lymph node metastasis. The results showed that tumor size, log odds of positive lymph nodes, radiotherapy, surgery, T stage, histology, and grade were significant independent predictors for survival. The nomograms exhibited good consistency between predictions and actual observations, with high C-index values. The study concluded that these nomograms can assist clinicians in decision-making and personalized treatment planning.
ObjectiveThe objective of this study was to establish and validate novel individualized nomograms for predicting the overall survival (OS) and cancer-specific survival (CSS) in cervical cancer patients with lymph node metastasis. MethodsA total of 2,956 cervical cancer patients diagnosed with lymph node metastasis (American Joint Committee on Cancer, AJCC N stage=N1) between 2000 and 2018 were included in this study. Univariate and multivariate Cox regression models were applied to identify independent prognostic predictors, and the nomograms were established to predict the OS and CSS. The concordance index (C-index), calibration curves, and receiver operating characteristic (ROC) curves were applied to estimate the precision and discriminability of the nomograms. Decision-curve analysis (DCA) was used to assess the clinical utility of the nomograms. ResultsTumor size, log odds of positive lymph nodes (LODDS), radiotherapy, surgery, T stage, histology, and grade resulted as significant independent predictors both for OS and CSS. The C-index value of the prognostic nomogram for predicting OS was 0.788 (95% CI, 0.762-0.814) and 0.777 (95% CI, 0.758-0.796) in the training and validation cohorts, respectively. Meanwhile, the C-index value of the prognostic nomogram for predicting CSS was 0.792 (95% CI, 0.767-0.817) and 0.781 (95% CI, 0.764-0.798) in the training and validation cohorts, respectively. The calibration curves for the nomograms revealed gratifying consistency between predictions and actual observations for both 3- and 5-year OS and CSS. The 3- and 5-year area under the curves (AUCs) for the nomogram of OS and CSS ranged from 0.781 to 0.828. Finally, the DCA curves emerged as robust positive net benefits across a wide scale of threshold probabilities. ConclusionWe have successfully constructed nomograms that could predict 3- and 5-year OS and CSS of cervical cancer patients with lymph node metastasis and may assist clinicians in decision-making and personalized treatment planning.
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