Validation of Nomograms for Survival and Metastases after Hysterectomy and Adjuvant Therapy in Uterine Cervical Cancer with Risk Factors.

. Three nomogram models for early stage uterine cervical cancer have been developed (KROG 13-03 for overall survival [OS], SNUH/AMC for disease-free survival [DFS], and KROG 12-08 for distant metastases-free survival [DMFS]) after radical hysterectomy (RH) and pelvic lymph node dissection (PLND). This study aimed to validate these models using our cohort with adjuvant radiotherapy. . According to the eligibility criteria of nomogram studies, patients were enrolled in Group A ( = 109) for the two KROG models (RH with PLND and whole pelvic irradiation) and Group B ( = 101) for the SNUH/AMC model (RH with PLND and squamous histology). Using Cox-regression hazard models, the prognostic factors of our cohorts were evaluated. The risk probabilities induced from published nomogram scores were calculated and the concordance indices were evaluated. . Group A had 88.1% 5-year OS and 86.0% 5-year DMFS. Group B had 83.0% 5-year DFS. In multivariate analyses, large tumor size for OS (HR 8.62, < 0.001) and DMFS (HR 5.13, = 0.003), young age (≤40 versus 41-64 years) for OS (HR 4.63, = 0.097) and DFS (HR 3.44, = 0.051), and multiple lymph node metastases (0 versus ≥3) for DMFS (HR 4.03, = 0.031) and DFS (HR 3.90, = 0.038) were significantly correlated. The concordance indices for OS, DMFS, and DFS were 0.612 ( = 0.002), 0.597 ( = 0.014), and 0.587 ( = 0.020), respectively. . The developed nomogram models after RH and PLND are clinically useful in predicting various types of survival with significance.