Prognostic risk model development and prospective validation among patients with cervical cancer stage IB2 to IIB submitted to neoadjuvant chemotherapy.
This study was designed to develop a risk model for disease recurrence among cervical cancer patients who underwent neoadjuvant chemotherapy and radical surgery. Data for 853 patients were obtained from a retrospective study and used to train the model, and then data for 447 patients from a prospective cohort study were employed to validate the model. The Cox regression model was used for calculating the coefficients of the risk factors. According to risk scores, patients were classified into high-, intermediate-, and low-risk groups. There were 49 (49/144, 34%) recurrences observed in the high-risk group (with a risk score ≥ 2.65), compared with 3 (3/142, 2%) recurrences in the low-risk group (with a risk score < 0.90). Disease-free survival (DFS) was significantly different (log-rank p < 0.001) among the three risk groups; the risk model also revealed a significant increase in the accuracy of predicting 5-year DFS with the area under the ROC curve (AUC = 0.754 for risk model vs 0.679 for FIGO stage system); the risk model was also validated with data from the prospective study (log-rank p < 0.001, AUC = 0.766). Both high-risk and intermediate-risk patients can be more effectively identified by this risk model.
From Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Kecheng
K
Huang
From Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Haiying
H
Sun
Department of Obstetrics and Gynecology, Wuhan Central Hospital, Wuhan, Hubei, China.
Xiong
X
Li
From Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Ting
T
Hu
Henan Cancer Hospital, Zhengzhou, Henan, China.
Ru
R
Yang
From Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
ShaoShuai
S
Wang
From Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Yao
Y
Jia
Department of Obstetrics and Gynecology, Wuhan General Hospital of Guangzhou Military Command, Wuhan, Hubei, China.
Zhilan
Z
Chen
From Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Fangxu
F
Tang
Department of Obstetrics and Gynecology, Wuhan Central Hospital, Wuhan, Hubei, China.
Jian
J
Shen
Department of Obstetrics and Gynecology, Xiangfan Central Hospital, Tongji Medical College, Huazhong University of Science and Technology, Xiangfan, Hubei, China.
Xiaomin
X
Qin
Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China.
Hang
H
Zhou
Hubei Tumor Hospital, Wuhan, Hubei, China.
Runfeng
R
Yang
Renmin Hospital, Wuhan University, Wuhan, Hubei, China.
Juan
J
Gui
From Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Lin
L
Wang
Tai-He Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
Xiaolin
X
Zhao
Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Jincheng
J
Zhang
Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Jiong
J
Liu
Tai-He Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
Lili
L
Guo
From Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Shuang
S
Li
From Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Shixuan
S
Wang
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D019540:Area Under Curve; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D012189:Retrospective Studies; D012306:Risk; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000188:drug therapy*
D000970:Antineoplastic Agents