Department of Gynecologic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
Curr Oncol. 2023 Mar 13;30(3):3289-3300. doi: 10.3390/curroncol30030250.
To develop a nomogram for predicting lymph node metastasis (LNM) in patients with epithelial ovarian cancer (EOC).
Between December 2012 and August 2022, patients with EOC who received computed tomography (CT) and serological examinations and were treated with upfront staging or debulking surgery were included. Systematic pelvic and para-aortic lymphadenectomy was performed in all patients. Univariate and multivariate analysis was used to identify significant risk factors associated with LNM. A nomogram was then constructed to assess the risk of LNM, which was evaluated with respect to its area under the receiver operating characteristic curve (AUC), calibration, and clinical usefulness.
Of 212 patients enrolled in this study, 78 (36.8%) had positive LNs. The nomogram integrating CT-reported LN status, child-bearing status, tumour laterality, and stage showed good calibration and discrimination with an AUC of 0.775, significantly improving performance over the CT results (0.699, = 0.0002) with a net reclassification improvement of 0.593 ( < 0.001) and integrated discrimination improvement of 0.054 ( < 0.001). The decision curve analysis showed the nomogram was of clinical use.
A nomogram was constructed and internally validated, which may act as a decision aid in patients with EOC being considered for systemic lymphadenectomy.
建立上皮性卵巢癌（EOC）患者淋巴结转移（LNM）预测的列线图。
本研究纳入了 2012 年 12 月至 2022 年 8 月间接受 CT 和血清学检查且行初始分期或肿瘤细胞减灭术治疗的 EOC 患者。所有患者均行系统的盆腔和腹主动脉旁淋巴结切除术。采用单因素和多因素分析确定与 LNM 相关的显著危险因素。然后构建列线图来评估 LNM 的风险，并通过受试者工作特征曲线（ROC）下面积（AUC）、校准度和临床实用性来进行评估。
本研究共纳入 212 例患者，其中 78 例（36.8%）存在阳性淋巴结。整合 CT 报告的淋巴结状态、生育状况、肿瘤侧别和分期的列线图具有良好的校准度和区分度，AUC 为 0.775，显著优于 CT 结果（0.699，<0.001），净重新分类改善为 0.593（<0.001），综合判别改善为 0.054（<0.001）。决策曲线分析表明该列线图具有临床应用价值。
本研究构建并内部验证了列线图，可作为考虑行系统性淋巴结切除术的 EOC 患者的决策辅助工具。
