title: Nomogram to predict recurrence in patients with early- and advanced-stage mucinous and serous borderline ovarian tumors.
abstract: OBJECTIVE
  Recurrence prediction is a cornerstone of patient management for borderline ovarian tumors. This study aimed to develop a nomogram predicting the recurrence probability in individual patients who had received primary surgical treatment.
  
  
  METHODS
  This retrospective multicenter study included 186 patients with borderline ovarian tumor diagnosed from January 1980 through December 2008. A multivariate logistic regression analysis of selected prognostic features was performed and a nomogram to predict recurrence was constructed. The nomogram was internally validated.
  
  
  RESULTS
  The overall recurrence rate was 34.4% (64/186), with noninvasive and invasive forms in 29% (54/186) and 5.4% (10/186) of cases, respectively. International Federation of Gynecology and Obstetrics stage, age at diagnosis, histologic subtype, completeness of surgery, and type of surgery (radical vs fertility sparing) were associated with an increased risk of recurrence and were included in the nomogram. The predictive model had a concordance index of 0.78 (95% confidence interval, 0.76-0.80) and 0.77 (95% confidence interval, 0.75-0.79) before and after the 200 repetitions of bootstrap sample corrections, respectively, and showed good calibration.
  
  
  CONCLUSIONS
  Our results support the use of the present nomogram based on 5 clinical and pathological characteristics to predict recurrence probability with a high concordance, hence to inform patients on surgical management. External validation is required to recommend this nomogram in routine practice.
authors.affiliation: Department of Obstetrics and Gynecology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Institut Universitaire de Cancérologie, Paris, France; Institut National de la Santé et de la Recherche Médicale (INSERM) UMR_S 707, "Epidemiology, Information Systems, Modeling", Université Pierre et Marie Curie, Paris, France. Electronic address: sofiane.bendifallah@yahoo.fr.
authors.forename: Sofiane
authors.initials: S
authors.lastname: Bendifallah
authors.affiliation: Department of Obstetrics and Gynecology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Institut Universitaire de Cancérologie, Paris, France; INSERM UMR_S 938, Université Pierre et Marie Curie, Paris, France.
authors.forename: Marcos
authors.initials: M
authors.lastname: Ballester
authors.affiliation: Department of Gynecologic Surgery and INSERM U 10-30, Institut Gustave Roussy, Villejuif, and Université Paris-Sud, Le Kremlin Bicêtre, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Uzan
authors.affiliation: Department of Obstetrics and Gynecology, Centre hospitalier Universitaire and INSERM ERI-12, Université de Picardie Jules Vernes, Amiens, France.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Fauvet
authors.affiliation: Department of Gynecologic Surgery and INSERM U 10-30, Institut Gustave Roussy, Villejuif, and Université Paris-Sud, Le Kremlin Bicêtre, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Morice
authors.affiliation: Department of Obstetrics and Gynecology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Institut Universitaire de Cancérologie, Paris, France; INSERM UMR_S 938, Université Pierre et Marie Curie, Paris, France.
authors.forename: Emile
authors.initials: E
authors.lastname: Darai
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000077216:Carcinoma, Ovarian Epithelial; D015331:Cohort Studies; D015653:Cystectomy; D005260:Female; D059247:Fertility Preservation; D006801:Humans; D007044:Hysterectomy; D016015:Logistic Models; D008197:Lymph Node Excision; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000473:pathology* / Q000601:surgery; D049451:Nomograms; D059351:Organ Sparing Treatments; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery; D010052:Ovariectomy; D011379:Prognosis; D012189:Retrospective Studies; D058994:Salpingectomy; D001743:Urinary Bladder / Q000473:pathology*
keywords: borderline ovarian tumors; conservative treatment; nomogram; recurrence; surgery