title: External validation of a nomogram for predicting survival of women with uterine cancer in a cohort of African American patients.
abstract: OBJECTIVE
  This study aimed to externally validate a nomogram for predicting overall survival of women with uterine cancer in an African American population.
  
  
  METHODS
  After the institutional review board approval, data from the uterine cancer database from 2 major teaching hospitals in Brooklyn, NY, were analyzed. The predicted survival for each patient was calculated with the use of the nonogram; the data were clustered in deciles and compared with the observed survival data.
  
  
  RESULTS
  High incidence of aggressive histologic types (22% carcinosarcoma, 16% serous/clear cell), poorly differentiated (53% grade 3), and advanced stage (38% stage III or IV) tumors was found in our study population. The median follow-up for survivors was 52 months (range, 1-274 months). The observed and predicted 3-year overall survival probabilities were significantly different (62.5% vs 72.6%, P < 0.001). Similarly, the observed 5-year overall survival probability was significantly lower than the predicted by the nomogram (55.5% vs 63.4%, P < 0.001). The discrepancy between predicted and observed survival was more pronounced in the midrisk groups.
  
  
  CONCLUSIONS
  The nomogram is not an adequate tool to predict survival in the African American population with cancer of the uterine corpus. Race seems to be a significant, independent factor that affects survival and should be included in predictive models.
authors.affiliation: Departments of *Gynecologic Oncology, and †Statistics, SUNY Downstate Medical Center, Brooklyn, NY.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Alagkiozidis
authors.forename: Kirstie
authors.initials: K
authors.lastname: Wilson
authors.forename: Nicole
authors.initials: N
authors.lastname: Ruffner
authors.forename: Jeremy
authors.initials: J
authors.lastname: Weedon
authors.forename: Eli
authors.initials: E
authors.lastname: Serur
authors.forename: Katherine
authors.initials: K
authors.lastname: Economos
authors.forename: Ovadia
authors.initials: O
authors.lastname: Abulafia
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Lee
authors.forename: Ghadir
authors.initials: G
authors.lastname: Salame
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality*; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D002296:Carcinosarcoma / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D049451:Nomograms; D011237:Predictive Value of Tests; D014594:Uterine Neoplasms / Q000401:mortality*