Ma Fanghua, Huang Jiesheng
Department of ultrasound, The First People's Hospital of Linping District, Hangzhou, Zhejiang, China.
J Obstet Gynaecol Res. 2025 Jan;51(1):e16214. doi: 10.1111/jog.16214.
This study aims to identify prognostic factors for elderly patients with endometrial cancer and to develop a nomogram for predicting cancer-specific survival in this population.
Clinicopathological data of elderly patients diagnosed with endometrial cancer between 2004 and 2015 were extracted from the SEER database. Patients were randomly assigned to either a training cohort or a validation cohort at a ratio of 7:3. Univariate and multivariable Cox regression analyses were performed to identify independent prognostic factors. A nomogram was then constructed based on these factors, and its predictive accuracy and discriminative ability were assessed using the C-index, receiver operating characteristic (ROC), and calibration curve.
Multivariate analysis identified age, marital status, grade, Federation of International of Gynecology and Obstetrics, surgery, chemotherapy, radiation, and tumor size as independent prognostic factors for elderly patients with endometrial carcinoma. Nomograms derived from these factors demonstrated excellent calibration and discrimination. The C-indexes were 0.83 for the training set and 0.82 for the validation set. The area under the curve (AUC) values for the training set were 0.88, 0.87, and 0.86 at 1, 3, and 5 year respectively. Corresponding AUC values for the validation set were 0.89, 0.86, and 0.86. Calibration curves for both cohorts demonstrated close alignment with the diagonal, indicating robust agreement between nomogram predictions and actual outcomes.
A novel nomogram has been developed for personalized prognosis assessment in elderly patients with endometrial carcinoma, aiming to enhance tailored treatment strategies and clinical management.
本研究旨在确定老年子宫内膜癌患者的预后因素，并开发一种列线图以预测该人群的癌症特异性生存情况。
从监测、流行病学与最终结果（SEER）数据库中提取2004年至2015年期间诊断为子宫内膜癌的老年患者的临床病理数据。患者按7:3的比例随机分配到训练队列或验证队列。进行单因素和多因素Cox回归分析以确定独立预后因素。然后基于这些因素构建列线图，并使用C指数、受试者操作特征（ROC）曲线和校准曲线评估其预测准确性和判别能力。
多因素分析确定年龄、婚姻状况、分级、国际妇产科联盟分期、手术、化疗、放疗和肿瘤大小为老年子宫内膜癌患者的独立预后因素。由这些因素得出的列线图显示出良好的校准和判别能力。训练集的C指数为0.83，验证集的C指数为0.82。训练集在1年、3年和5年时的曲线下面积（AUC）值分别为0.88、0.87和0.86。验证集的相应AUC值为0.89、0.86和0.86。两个队列的校准曲线均显示与对角线紧密对齐，表明列线图预测与实际结果之间具有高度一致性。
已开发出一种新型列线图用于老年子宫内膜癌患者的个性化预后评估，旨在加强个性化治疗策略和临床管理。
