title: Individualized prediction of overall survival after postoperative radiation therapy in patients with early-stage cervical cancer: a Korean Radiation Oncology Group study (KROG 13-03).
abstract: OBJECTIVE
  A nomogram is a predictive statistical model that generates the continuous probability of a clinical event such as death or recurrence. The aim of the study was to construct a nomogram to predict 5-year overall survival after postoperative radiation therapy for stage IB to IIA cervical cancer.
  
  
  METHODS
  The clinical data from 1702 patients with early-stage cervical cancer, treated at 10 participating hospitals from 1990 to 2011, were reviewed to develop a prediction nomogram based on the Cox proportional hazards model. Demographic, clinical, and pathologic variables were included and analyzed to formulate the nomogram. The discrimination and calibration power of the model was measured using a concordance index (c-index) and calibration curve.
  
  
  RESULTS
  The median follow-up period for surviving patients was 75.6 months, and the 5-year overall survival probability was 87.1%. The final model was constructed using the following variables: age, number of positive pelvic lymph nodes, parametrial invasion, lymphovascular invasion, and the use of concurrent chemotherapy. The nomogram predicted the 5-year overall survival with a c-index of 0.69, which was superior to the predictive power of the International Federation of Gynecology and Obstetrics (FIGO) staging system (c-index of 0.54).
  
  
  CONCLUSIONS
  A survival-predicting nomogram that offers an accurate level of prediction and discrimination was developed based on a large multi-center study. The model may be more useful than the FIGO staging system for counseling individual patients regarding prognosis.
authors.affiliation: Department of Radiation Oncology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Republic of Korea.
authors.forename: Hyun Jin
authors.initials: HJ
authors.lastname: Lee
authors.forename: Seungbong
authors.initials: S
authors.lastname: Han
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Kim
authors.forename: Joo-Hyun
authors.initials: JH
authors.lastname: Nam
authors.forename: Hak Jae
authors.initials: HJ
authors.lastname: Kim
authors.forename: Jae Weon
authors.initials: JW
authors.lastname: Kim
authors.forename: Won
authors.initials: W
authors.lastname: Park
authors.forename: Byoung-Gie
authors.initials: BG
authors.lastname: Kim
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Kim
authors.forename: Soon Do
authors.initials: SD
authors.lastname: Cha
authors.forename: Juree
authors.initials: J
authors.lastname: Kim
authors.forename: Ki-Heon
authors.initials: KH
authors.lastname: Lee
authors.forename: Mee Sun
authors.initials: MS
authors.lastname: Yoon
authors.forename: Seok Mo
authors.initials: SM
authors.lastname: Kim
authors.forename: Ji-Yoon
authors.initials: JY
authors.lastname: Kim
authors.forename: Won Sup
authors.initials: WS
authors.lastname: Yoon
authors.forename: Nak Woo
authors.initials: NW
authors.lastname: Lee
authors.forename: Jin Hwa
authors.initials: JH
authors.lastname: Choi
authors.forename: Sang-Yoon
authors.initials: SY
authors.lastname: Park
authors.forename: Joo-Young
authors.initials: JY
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy* / Q000628:therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods / Q000401:mortality; D008198:Lymph Nodes / Q000473:pathology; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D049451:Nomograms; D010388:Pelvis; D011379:Prognosis; D016016:Proportional Hazards Models; D056910:Republic of Korea; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy* / Q000628:therapy; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents