title: Nomogram prediction for overall survival of patients diagnosed with cervical cancer.
abstract: BACKGROUND
  Nomograms are predictive tools that are widely used for estimating cancer prognosis. The aim of this study was to develop a nomogram for the prediction of overall survival (OS) in patients diagnosed with cervical cancer.
  
  
  METHODS
  Cervical cancer databases of two large institutions were analysed. Overall survival was defined as the clinical endpoint and OS probabilities were estimated using the Kaplan-Meier method. Based on the results of survival analyses and previous studies, relevant covariates were identified, a nomogram was constructed and validated using bootstrap cross-validation. Discrimination of the nomogram was quantified with the concordance probability.
  
  
  RESULTS
  In total, 528 consecutive patients with invasive cervical cancer, who had all nomogram variables available, were identified. Mean 5-year OS rates for patients with International Federation of Gynecologists and Obstetricians (FIGO) stage IA, IB, II, III, and IV were 99.0%, 88.6%, 65.8%, 58.7%, and 41.5%, respectively. Seventy-six cancer-related deaths were observed during the follow-up period. FIGO stage, tumour size, age, histologic subtype, lymph node ratio, and parametrial involvement were selected as nomogram covariates. The prognostic performance of the model exceeded that of FIGO stage alone and the model's estimated optimism-corrected concordance probability was 0.723, indicating accurate prediction of OS. We present the prediction model as nomogram and provide a web-based risk calculator (http://www.ccc.ac.at/gcu).
  
  
  CONCLUSIONS
  Based on six easily available parameters, a novel statistical model to predict OS of patients diagnosed with cervical cancer was constructed and validated. The model was implemented in a nomogram and provides accurate prediction of individual patients' prognosis useful for patient counselling and deciding on follow-up strategies.
authors.affiliation: Department of General Gynecology and Gynecologic Oncology, Comprehensive Cancer Center, Medical University of Vienna, Austria. stephan.polterauer@meduniwien.ac.at
authors.forename: S
authors.initials: S
authors.lastname: Polterauer
authors.forename: C
authors.initials: C
authors.lastname: Grimm
authors.forename: G
authors.initials: G
authors.lastname: Hofstetter
authors.forename: N
authors.initials: N
authors.lastname: Concin
authors.forename: C
authors.initials: C
authors.lastname: Natter
authors.forename: A
authors.initials: A
authors.lastname: Sturdza
authors.forename: R
authors.initials: R
authors.lastname: Pötter
authors.forename: C
authors.initials: C
authors.lastname: Marth
authors.forename: A
authors.initials: A
authors.lastname: Reinthaller
authors.forename: G
authors.initials: G
authors.lastname: Heinze
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001317:Austria / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D049451:Nomograms; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D002583:Uterine Cervical Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D044465:White People / Q000706:statistics & numerical data