Yang Xi, An Jusheng, Zhang Yuanyuan, Yang Yong, Chen Siye, Huang Manni, Wu Lingying
Department of Gynecological Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Oncol. 2020 Oct 20;10:591700. doi: 10.3389/fonc.2020.591700. eCollection 2020.
To develop nomograms to assess prognostic factors for 5-year overall survival (OS) and 5-year progression-free survival (PFS) in locally advanced cervical squamous cell carcinoma (LACSC).
Overall, 618 patients with LACSC were included in this retrospective analysis. Nomograms for 5-year OS and PFS were developed based on Cox proportional hazards regression models. Concordance index (C-index) and calibration curves were used to define the predictive and discriminatory capacity of the nomogram. A comparison between the nomogram and the International Federation of Gynecology and Obstetrics (FIGO) staging system was conducted using time-dependent receiver operating characteristic (tROC) and area under the curve (tAUC).
Multivariate analysis identified several prognostic factors for OS including squamous cell carcinoma antigen (SCC-Ag), body mass index (BMI), tumor size, pelvic wall involvement, and para-aortic lymph node metastasis (PALNM). Prognostic factors for PFS included BMI, hemoglobin (HGB), tumor size, pelvic wall involvement, pelvic lymph node metastasis (PLNM) and PALNM. Following bootstrap correction, the C-index of OS and PFS was 0.713 and 0.686, respectively. These nomograms showed superior performance compared with the FIGO 2009 and 2018 staging schema.
Nomograms were developed to identify prognostic factors for 5-year OS and PFS in patients with LACSC. These nomograms showed good prognostication and are more comprehensive in predicting survival outcomes than existing staging criteria.
建立列线图以评估局部晚期宫颈鳞状细胞癌（LACSC）患者5年总生存期（OS）和5年无进展生存期（PFS）的预后因素。
本回顾性分析共纳入618例LACSC患者。基于Cox比例风险回归模型建立5年OS和PFS的列线图。一致性指数（C指数）和校准曲线用于定义列线图的预测和鉴别能力。使用时间依赖性受试者工作特征曲线（tROC）和曲线下面积（tAUC）对列线图与国际妇产科联盟（FIGO）分期系统进行比较。
多因素分析确定了几个OS的预后因素，包括鳞状细胞癌抗原（SCC-Ag）、体重指数（BMI）、肿瘤大小、盆腔壁受累情况和腹主动脉旁淋巴结转移（PALNM）。PFS的预后因素包括BMI、血红蛋白（HGB）、肿瘤大小、盆腔壁受累情况、盆腔淋巴结转移（PLNM）和PALNM。经自抽样校正后，OS和PFS的C指数分别为0.713和0.686。这些列线图与FIGO 2009和2018分期方案相比表现更优。
建立了列线图以识别LACSC患者5年OS和PFS的预后因素。这些列线图显示出良好的预后预测能力，并且在预测生存结局方面比现有分期标准更全面。
