title: External validation of nomograms designed to predict lymphatic dissemination in patients with early-stage endometrioid endometrial cancer: a multicenter study.
abstract: OBJECTIVE
  The objective of the study was to externally validate and assess the robustness of 2 nomograms designed to predict the probability of lymphatic dissemination (LD) for patients with early-stage endometrioid endometrial cancer.
  
  
  METHODS
  Using a prospective multicenter database, we assessed the discrimination, calibration, and clinical utility of 2 nomograms in patients with surgically treated early-stage endometrioid endometrial cancer.
  
  
  RESULTS
  Among the 322 eligible patients identified, the overall LD rate was 9.9% (32 of 322). Predictive accuracy according to discrimination was 0.65 (95% confidence interval, 0.61-0.69) for the full nomogram and 0.71 (95% confidence interval, 0.68-0.74) for the alternative nomogram. The correspondence between observed recurrence rate and the nomogram predictions suggests a moderate calibration of the nomograms in the validation cohort.
  
  
  CONCLUSIONS
  The nomograms were externally validated and shown to be partly generalizable to a new and independent patient population. Although these tools provide a more individualized estimation of LD, additional parameters are needed to allow higher accuracy for counseling patients in clinical practice.
authors.affiliation: Department of Obstetrics and Gynecology, Tenon University Hospital, University Pierre and Marie Curie, Paris, France; Department of Epidemiology, Information Systems, and Modeling, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche en Santé 707, University Pierre and 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, Tenon University Hospital, University Pierre and Marie Curie, Paris, France.
authors.forename: Geoffroy
authors.initials: G
authors.lastname: Canlorbe
authors.affiliation: Department of Obstetrics and Gynecology, Institute Alix de Champagne University Hospital, Reims, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Raimond
authors.affiliation: Centre de Lutte Contre le Cancer Georges François Leclerc, Dijon, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Hudry
authors.affiliation: Centre de Lutte Contre le Cancer Georges François Leclerc, Dijon, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Coutant
authors.affiliation: Department of Obstetrics and Gynecology, Institute Alix de Champagne University Hospital, Reims, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Graesslin
authors.affiliation: Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal, Créteil, France.
authors.forename: Cyril
authors.initials: C
authors.lastname: Touboul
authors.affiliation: Department of Radiation Oncology, Tenon University Hospital, University Pierre and Marie Curie, Paris, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Huguet
authors.affiliation: Department of Pathology, Tenon University Hospital, University Pierre and Marie Curie, Paris, France.
authors.forename: Annie
authors.initials: A
authors.lastname: Cortez
authors.affiliation: Department of Obstetrics and Gynecology, Tenon University Hospital, University Pierre and Marie Curie, Paris, France; Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche en Santé 938, University Pierre and Marie Curie, Paris, France.
authors.forename: Emile
authors.initials: E
authors.lastname: Daraï
authors.affiliation: Department of Obstetrics and Gynecology, Tenon University Hospital, University Pierre and Marie Curie, Paris, France; Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche en Santé 938, University Pierre and Marie Curie, Paris, France.
authors.forename: Marcos
authors.initials: M
authors.lastname: Ballester
mesh_terms: D018269:Carcinoma, Endometrioid / Q000556:secondary*; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D049451:Nomograms; D011446:Prospective Studies
keywords: endometrial cancer; lymphatic dissemination; nomogram; validation