Nomogram prediction of overall survival after curative irradiation for uterine cervical cancer.
OBJECTIVE
The purpose of this study was to develop a nomogram capable of predicting the probability of 5-year survival after radical radiotherapy (RT) without chemotherapy for uterine cervical cancer.


METHODS
We retrospectively analyzed 549 patients that underwent radical RT for uterine cervical cancer between March 1994 and April 2002 at our institution. Multivariate analysis using Cox proportional hazards regression was performed and this Cox model was used as the basis for the devised nomogram. The model was internally validated for discrimination and calibration by bootstrap resampling.


RESULTS
By multivariate regression analysis, the model showed that age, hemoglobin level before RT, Fédération Internationale de Gynécologie Obstétrique (FIGO) stage, maximal tumor diameter, lymph node status, and RT dose at Point A significantly predicted overall survival. The survival prediction model demonstrated good calibration and discrimination. The bootstrap-corrected concordance index was 0.67. The predictive ability of the nomogram proved to be superior to FIGO stage (p=0.01).


CONCLUSIONS
The devised nomogram offers a significantly better level of discrimination than the FIGO staging system. In particular, it improves predictions of survival probability and could be useful for counseling patients, choosing treatment modalities and schedules, and designing clinical trials. However, before this nomogram is used clinically, it should be externally validated.
Seo
YoungSeok
Y
Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul, Korea.
Yoo
Seong Yul
SY
Kim
Mi-Sook
MS
Yang
Kwang Mo
KM
Yoo
Hyung Jun
HJ
Kim
Jin Ho
JH
Shin
Young-Joo
YJ
Kang
Jin Kyu
JK
Lee
Kyung Hee
KH
Lee
Eui Don
ED
Rhu
Sang Young
SY
Choi
Suck Chul
SC
Kim
Moon Hong
MH
Kim
Beob Jong
BJ
Kim
Min-Suk
MS
Cho
Chul-Koo
CK
D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006441:Hemoglobin A / Q000032:analysis; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D049451:Nomograms; D011336:Probability; D016016:Proportional Hazards Models; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*
D006441:Hemoglobin A