Lee Won Kee, Chong Gun Oh, Jeong Shin Young, Lee Hyun Jung, Park Shin-Hyung, Ryu Jung Min, Choi Youn Seok, Kang Sungmin, Koo Yu-Jin, Lee Dae Hyung, Kong Eunjung, Lee Sang-Woo
Medical Research Collaboration Center in Kyungpook National University Hospital, Department of Medical Informatics, School of Medicine, Kyungpook National University, Daegu 41944, Korea.
Department of Obstetrics and Gynecology, Kyungpook National University Chilgok Hospital, Daegu 41404, Korea.
J Clin Med. 2020 Feb 5;9(2):427. doi: 10.3390/jcm9020427.
This study aimed to develop a prognosis-predicting model based on [F]fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) and clinicopathologic factors in locally advanced cervical cancer patients treated with concurrent chemoradiotherapy (CCRT). The medical records of 270 locally advanced cervical cancer patients who were treated with CCRT were collected from three institutions and reviewed retrospectively. A nomogram was used for predicting 2-year disease-free survival (DFS) and 5-year overall survival (OS) based on Cox proportional hazards regression. Predictor variables included nodal maximum standardized uptake value (SUVmax), primary tumor SUVmax, age, tumor size, stage, serum squamous cell carcinoma antigen level, and human papillomavirus status. Internal nomogram validation was performed. A nomogram for predicting the 2-year DFS and 5-year OS was constructed using six and seven parameters, respectively. With a focus on 2-year DFS, our model found nodal SUVmax to be the highest weighted negative prognostic factor. With a focus on 5-year OS, young age was the highest weighted negative prognostic factor. The concordance index was 0.75 and 0.78 for the 2-year DFS and 5-year OS, respectively. This nomogram is a predictive tool that can be used to counsel patients for predicting survival outcomes. Moreover, our prognosis-predicting model may make it possible to personalize treatment.
本研究旨在基于[F]氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）及临床病理因素，为接受同步放化疗（CCRT）的局部晚期宫颈癌患者建立预后预测模型。我们从三个机构收集了270例接受CCRT治疗的局部晚期宫颈癌患者的病历，并进行回顾性分析。基于Cox比例风险回归，使用列线图预测2年无病生存率（DFS）和5年总生存率（OS）。预测变量包括淋巴结最大标准化摄取值（SUVmax）、原发肿瘤SUVmax、年龄、肿瘤大小、分期、血清鳞状细胞癌抗原水平和人乳头瘤病毒状态。进行了内部列线图验证。分别使用六个和七个参数构建了预测2年DFS和5年OS的列线图。聚焦于2年DFS时，我们的模型发现淋巴结SUVmax是权重最高的负性预后因素。聚焦于5年OS时，年轻是权重最高的负性预后因素。2年DFS和5年OS的一致性指数分别为0.75和0.78。该列线图是一种可用于为患者提供生存结果预测咨询的工具。此外，我们的预后预测模型可能使个性化治疗成为可能。
