title: A risk scoring system to determine recurrence in early-stage type 1 endometrial cancer: a French multicentre study.
abstract: BACKGROUND
  To develop a risk scoring system (RSS) to determine recurrence in women with early-stage type 1 endometrial cancer (EC).
  
  
  METHODS
  Data of 396 women with early-stage type 1 EC who received primary surgical treatment between January 2001 and December 2012 were abstracted from multicentre database (training set). A risk model for predicting recurrence was developed and internally validated with the bootstrap technique. The RSS was externally validated using data from an independent population.
  
  
  RESULTS
  Overall, the recurrence rate was 12.1 %. The median follow-up and initial time to recurrence were 34 (range 1-152) and 26 (range 1-151) months, respectively. Recurrence was associated with five variables: age ≥60 years, histological grade III, primary tumor diameter >2 cm, depth of myometrial invasion ≥50 %, and the positive lymphovascular space involvement status. These variables were included in the RSS and assigned scores. A total score of 6.5 points corresponded to the optimal threshold of the RSS. For women with a score <6.5 or ≥6.5, the recurrence rates were 8.4 % (30/357) and 48.7 % (19/39) in the training set, respectively. At this threshold, the diagnostic accuracy of the RSS was 87 %. Areas under the curve of the receiver-operating characteristics for predicting recurrence at internal and external validation were 0.74 [95 % confidence interval (CI) 0.71-0.77] and 0.82 (95 % CI 79-85), respectively.
  
  
  CONCLUSIONS
  This RSS identified two subsets of women with low and high risk of recurrence among women with early-stage type 1 EC. It could be helpful to better define indications for nodal staging and adjuvant therapy.
authors: Department of Obstetrics and Gynaecology, Tenon University Hospital, CHU Tenon, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC), Paris, France, sofiane.bendifallah@yahoo.fr.
authors: Sofiane
authors: S
authors: Bendifallah
authors: Geoffroy
authors: G
authors: Canlorbe
authors: Florence
authors: F
authors: Huguet
authors: Charles
authors: C
authors: Coutant
authors: Delphine
authors: D
authors: Hudry
authors: Olivier
authors: O
authors: Graesslin
authors: Emilie
authors: E
authors: Raimond
authors: Cyril
authors: C
authors: Touboul
authors: Pierre
authors: P
authors: Collinet
authors: Géraldine
authors: G
authors: Bleu
authors: Emile
authors: E
authors: Daraï
authors: Marcos
authors: M
authors: Ballester
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000145:classification / Q000401:mortality* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D008875:Middle Aged; D009215:Myometrium / Q000473:pathology; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000401:mortality; D009367:Neoplasm Staging; D011379:Prognosis; D012372:ROC Curve; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate