title: Evaluation of models to predict lymph node metastasis in endometrial cancer: A multicentre study.
abstract: Several models (preoperative and postoperative) have been developed to predict lymph node metastasis (LNM) in patients with endometrial cancer. The purpose of our investigation was to compare available models in a multicentre study.
  
  
  
  In a cohort of 519 patients with endometrial cancer who had undergone primary hysterectomy and at least a pelvic lymphadenectomy, we compared the areas under the receiver-operating characteristic curves (AUCs), calibrations, rates of false negatives (FN), and the number of patients at low-risk for LNM using ten different models (three preoperative and seven postoperative).
  
  
  
  In all, 17.5% of patients among the study population (91 in 519) had LNM. Only one of the three preoperative models and three of the seven postoperative models had an AUC >0.75. Six models were well calibrated. Eight models yielded an FN rate of <5%. Six models could assign more than a third of patients to the low-risk group. One postoperative (a French nomogram) and one preoperative (the Korean Gynecologic Oncology Group [KGOG]) model had an AUC >0.75, to yield an FN rate of <5%, and could assign more than a third of patients to the low-risk group.
  
  
  
  This study supports the use of the KGOG model to decide upon lymphadenectomy preoperatively in patients with endometrial cancer. For patients who did not have lymphadenectomy, a French nomogram could be applied using pathological characteristics to decide on a secondary lymphadenectomy.
authors.affiliation: Gynecologic Oncology, Bichat University Hospital, Paris Diderot University, Paris, France; EA7285, UVSQ, Montigny-le-Bretonneux, France; Gynecologic Oncology, University Hospitals Leuven, and Department of Oncology, KU Leuven, Leuven, Belgium. Electronic address: martin.koskas@wanadoo.fr.
authors.forename: Martin
authors.initials: M
authors.lastname: Koskas
authors.affiliation: Gynecologic Oncology, Bichat University Hospital, Paris Diderot University, Paris, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Fournier
authors.affiliation: Gynecologic Oncology, University Hospitals Leuven, and Department of Oncology, KU Leuven, Leuven, Belgium.
authors.forename: Anke
authors.initials: A
authors.lastname: Vanderstraeten
authors.affiliation: Department of Pathology, Bichat University Hospital, Paris Diderot University, Paris, France.
authors.forename: Francine
authors.initials: F
authors.lastname: Walker
authors.affiliation: Department of Development and Regeneration, University Hospitals Leuven, and Department of Oncology, KU Leuven, Leuven, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Timmerman
authors.affiliation: Gynecologic Oncology, University Hospitals Leuven, and Department of Oncology, KU Leuven, Leuven, Belgium.
authors.forename: Ignace
authors.initials: I
authors.lastname: Vergote
authors.affiliation: Gynecologic Oncology, University Hospitals Leuven, and Department of Oncology, KU Leuven, Leuven, Belgium; Centre for Gynecologic Oncology Amsterdam (CGOA), Antoni Van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Amant
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology*; D008875:Middle Aged; D015233:Models, Statistical; D011379:Prognosis; D055815:Young Adult
keywords: Endometrial cancer; Lymph node metastasis; Lymphadenectomy; Prediction