Rouzier Roman, Preti Mario, Haddad Bassam, Martin Michel, Micheletti Leonardo, Paniel Bernard-Jean
Department of Gynecology and Obstetrics, Centre Hospitalier Intercommunal de Créteil, University Paris 12, Créteil, France.
Obstet Gynecol. 2006 Mar;107(3):672-7. doi: 10.1097/01.AOG.0000198639.36855.e9.
To construct and validate a nomogram to predict relapse-free survival of patients treated for vulvar cancer.
Data from 244 patients treated for vulvar cancer at a single institution (Creteil, France) were used as a training set to develop and calibrate a nomogram for predicting relapse-free survival and local relapse-free survival. We used bootstrap resampling for the internal validation and we tested the nomogram on an independent validation set of patients (Torino, Italy) for the external validation.
The nomograms were based on a Cox proportional hazards regression model. Covariates for the relapse-free survival model included age, T stage, number of metastatic nodes, bilateral lymph node involvement, omission of the lymphadenectomy, margin status, lymphovascular space invasion, and depth of invasion. The concordance indices were 0.85 and 0.83 in the training set before and after bootstrapping, respectively, and 0.83 in the validation set. The predictions of our nomogram discriminated better than did the International Federation of Gynecology and Obstetrics stage (0.83 compared with 0.78, P = .01). The calibration of our nomogram was good. In the validation set, 2-year and 5-year relapse-free survival were well predicted with less than 5% difference between the predicted and observed survivals for each quartile. A nomogram for predicting local relapse was also developed.
We have developed nomograms for predicting distant and local relapse of vulvar cancer at 2 and 5 years and validated them both internally and externally. These nomograms will be freely available on the International Society for the Study of Vulvovaginal Disease Web site.
III.
构建并验证一种列线图，以预测接受外阴癌治疗患者的无复发生存率。
来自法国克雷泰伊一家机构接受外阴癌治疗的244例患者的数据用作训练集，以开发和校准用于预测无复发生存率和局部无复发生存率的列线图。我们使用自助重采样进行内部验证，并在一组独立的患者验证集（意大利都灵）上测试该列线图进行外部验证。
列线图基于Cox比例风险回归模型。无复发生存模型的协变量包括年龄、T分期、转移淋巴结数量、双侧淋巴结受累情况、未行淋巴结切除术、切缘状态、淋巴管间隙浸润和浸润深度。在训练集中，自助重采样前后的一致性指数分别为0.85和0.83，在验证集中为0.83。我们列线图的预测比国际妇产科联盟分期具有更好的区分度（0.83比0.78，P = 0.01）。我们列线图的校准良好。在验证集中，2年和5年无复发生存率得到了很好的预测，每个四分位数的预测生存率与观察到的生存率之间的差异小于5%。还开发了一种用于预测局部复发的列线图。
我们已开发出用于预测外阴癌2年和5年远处和局部复发的列线图，并在内部和外部进行了验证。这些列线图将在国际外阴阴道疾病研究学会网站上免费提供。
III级。
