Predicting poor prognosis recurrence in women with endometrial cancer: a nomogram developed by the FRANCOGYN study group.
BACKGROUND
The purpose of this study was to develop a nomogram to predict 'poor prognosis recurrence' (PPR) in women treated for endometrial cancer (EC).


METHODS
The data of 861 women who received primary surgical treatment between January 2001 and December 2013 were abstracted from a prospective multicenter database. Data were randomly split into two sets: training and validation with a predefined 2/3 ratio. A Cox proportional hazards multivariate model of selected prognostic features was performed in the training cohort (n=574) to develop a nomogram predicting PPRs. The nomogram was validated in the validation cohort of 287 patients.


RESULTS
In the training cohort, 82 (14.3%) developed subsequent PPR. Age, histologic type and grade, lymphovascular space invasion status, FIGO stage, and nodal staging (SLN±pelvic and/or para-aortic lymphadenectomy) were independently associated with subsequent PPR. The nomogram showed an area under the receiver operating characteristic curve (AUC) of 0.82 (95% confidence interval (CI), 0.73-0.89) in the training set. The validation set showed a good discrimination with an AUC of 0.75 (95% CI, 0.65-0.83).


CONCLUSIONS
We have developed a robust tool that is able to predict subsequent PPRs in women with FIGO I-III EC.
Department of Gynecology, Centre Hospitalier Universitaire de Tours, Tours, France.|INSERM U1069; Université François-Rabelais, 10 Boulevard Tonnellé, 3704 Tours, France.
Lobna
L
Ouldamer
Department of Obstetrics and Gynaecology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, GRC-6 UPMC, Université Pierre et Marie Curie, Paris, France.|UMR S 707, Epidemiology, Information Systems, Modeling, Université Pierre et Marie Curie, Paris, France.
Sofiane
S
Bendifallah
Department of Gynecology, Centre Hospitalier Universitaire de Tours, Tours, France.|INSERM U1069; Université François-Rabelais, 10 Boulevard Tonnellé, 3704 Tours, France.
Gilles
G
Body
Department of Obstetrics and Gynaecology, Centre Hospitalier Intercommunal, Créteil, France.
Cyril
C
Touboul
Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France.
Olivier
O
Graesslin
Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France.
Emilie
E
Raimond
Department of Gynecological surgery, Jeanne de Flandre University Hospital, Lille, France.
Pierre
P
Collinet
Centre de lutte Contre le Cancer Georges François Leclerc, Dijon, France.
Charles
C
Coutant
Departement of Gynecological Surgery, Rennes University Hospital, Rennes, France.
Vincent
V
Lavoué
Departement of Gynecological Surgery, Rennes University Hospital, Rennes, France.
Jean
J
Lévêque
Department of Obstetrics and Gynaecology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, GRC-6 UPMC, Université Pierre et Marie Curie, Paris, France.|INSERM UMR S 938, Université Pierre et Marie Curie, Paris, France.
Emile
E
Daraï
Department of Obstetrics and Gynaecology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, GRC-6 UPMC, Université Pierre et Marie Curie, Paris, France.|INSERM UMR S 938, Université Pierre et Marie Curie, Paris, France.
Marcos
M
Ballester
D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D049451:Nomograms; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D012306:Risk