Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, Korea.
Int J Gynecol Cancer. 2010 Dec;20(9):1581-6.
The aim of this study was to develop a nomogram for predicting the 5-year disease-free survival (DFS) after radical hysterectomy for early-stage cervical cancer.
An institutional database of 275 consecutive patients treated at Seoul National University Hospital for stage I to stage IIA cervical cancer was used to develop a nomogram based on Cox proportional hazards regression model. The developed nomogram was internally validated with bootstrapping, and performance was assessed by concordance index and a calibration curve. External validation was also performed using an independent data set of patients from Asan Medical Center.
From Cox regression analysis, disease stage, number of positive lymph nodes, parametrial involvement, and depth of invasion were identified as independent risk factors for disease recurrence (P < 0.05). The nomogram incorporating these factors appeared to be accurate and predicted the outcomes better than the International Federation of Gynecology and Obstetrics stage alone (concordance index, 0.858 compared with 0.719; P = 0.001). When applied to a separate validation set, the nomogram also showed similar predictive accuracy (concordance index, 0.879).
We have developed a nomogram that can predict the recurrence risk in patients with early-stage cervical cancer after surgery, which was internally and externally validated.
本研究旨在为早期宫颈癌根治性子宫切除术的 5 年无病生存率（DFS）建立一个列线图预测模型。
本研究使用了首尔国立大学医院的 275 例连续宫颈癌患者的机构数据库，基于 Cox 比例风险回归模型建立了一个列线图。通过自举法对内部分值进行了验证，并通过一致性指数和校准曲线评估了性能。使用来自 Asan 医疗中心的独立患者数据集进行了外部验证。
通过 Cox 回归分析，疾病分期、阳性淋巴结数量、宫旁侵犯和浸润深度被确定为疾病复发的独立危险因素（P < 0.05）。纳入这些因素的列线图似乎更准确，预测结果优于国际妇产科联合会（FIGO）分期单独使用（一致性指数，0.858 与 0.719；P = 0.001）。当应用于单独的验证集时，该列线图也显示出类似的预测准确性（一致性指数，0.879）。
我们已经开发了一个列线图，可以预测手术后早期宫颈癌患者的复发风险，该列线图经过了内部和外部验证。
