Tse Ka-Yu, Wong Richard Wing-Cheuk, Chao Angel, Ueng Shir-Hwa, Yang Lan-Yan, Cummings Margaret, Smith Deborah, Lai Chiung-Ru, Lau Hei-Yu, Yen Ming-Shyen, Cheung Annie Nga-Yin, Leung Charlotte Ka-Lun, Chan Kit-Sheung, Chan Alice Ngot-Htain, Li Wai-Hon, Choi Carmen Ka-Man, Pong Wai-Mei, Hui Hoi-Fong, Yuk Judy Ying-Wah, Yao Hung, Yuen Nancy Wah-Fun, Obermair Andreas, Lai Chyong-Huey, Ip Philip Pun-Ching, Ngan Hextan Yuen-Sheung
Department of Obstetrics and Gynaecology, the University of Hong Kong, Pokfulam, Hong Kong.
Department of Pathology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
Cancers (Basel). 2021 May 14;13(10):2378. doi: 10.3390/cancers13102378.
The existing staging systems of uterine leiomyosarcoma (uLMS) cannot classify the patients into four non-overlapping prognostic groups. This study aimed to develop a prediction model to predict the three-year survival status of uLMS.
In total, 201 patients with uLMS who had been treated between June 1993 and January 2014, were analyzed. Potential prognostic indicators were identified by univariate models followed by multivariate analyses. Prediction models were constructed by binomial regression with 3-year survival status as a binary outcome, and the final model was validated by internal cross-validation.
Nine potential parameters, including age, log tumor diameter, log mitotic count, cervical involvement, parametrial involvement, lymph node metastasis, distant metastasis, tumor circumscription and lymphovascular space invasion were identified. 110 patients had complete data to build the prediction models. Age, log tumor diameter, log mitotic count, distant metastasis, and circumscription were significantly correlated with the 3-year survival status. The final model with the lowest Akaike's Information Criterion (117.56) was chosen and the cross validation estimated prediction accuracy was 0.745.
We developed a prediction model for uLMS based on five readily available clinicopathologic parameters. This might provide a personalized prediction of the 3-year survival status and guide the use of adjuvant therapy, a cancer surveillance program, and future studies.
子宫平滑肌肉瘤（uLMS）现有的分期系统无法将患者分为四个互不重叠的预后组。本研究旨在开发一种预测模型，以预测uLMS患者的三年生存状况。
共分析了1993年6月至2014年1月期间接受治疗的201例uLMS患者。通过单变量模型识别潜在的预后指标，随后进行多变量分析。以三年生存状况作为二元结局，通过二项式回归构建预测模型，并通过内部交叉验证对最终模型进行验证。
确定了九个潜在参数，包括年龄、肿瘤直径对数、有丝分裂计数对数、宫颈受累、宫旁组织受累、淋巴结转移、远处转移、肿瘤边界和淋巴管间隙侵犯。110例患者有完整数据用于构建预测模型。年龄、肿瘤直径对数、有丝分裂计数对数、远处转移和边界与三年生存状况显著相关。选择了Akaike信息准则最低（117.56）的最终模型，交叉验证估计的预测准确率为0.745。
我们基于五个易于获得的临床病理参数开发了一种uLMS预测模型。这可能为三年生存状况提供个性化预测，并指导辅助治疗的使用、癌症监测计划和未来研究。
