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Prognostic Model for Survival and Recurrence in Patients with Early-Stage Cervical Cancer: A Korean Gynecologic Oncology Group Study (KGOG 1028)

Cancer Research and Treatment 2020년 52권 1호 p.320 ~ 333
 ( Paik E-Sun ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Obstetrics and Gynecology

임명철 ( Lim Myong-Cheol ) - National Cancer Center Center for Uterine Cancer
김문홍 ( Kim Moon-Hong ) - Korea Institute of Radiological and Medical Sciences Korea Cancer Center Hospital Department of Obstetrics & Gynecology
김윤환 ( Kim Yun-Hwan ) - Ewha Womans University School of Medicine Ewha Womans University Mokdong Hospital Department of Obstetrics and Gynecology
송은섭 ( Song Eun-Seop ) - Gwangjin-gu Health Center Medical Treatment Division
성석주 ( Seong Seok-Ju ) - CHA University CHA Gangnam Medical Center Department of Obstetrics and Gynecology
서동훈 ( Suh Dong-Hoon ) - Seoul National University Bundang Hospital Department of Obstetrics and Gynecology
이종민 ( Lee Jong-Min ) - Kyung Hee University School of Medicine Kyung Hee University Hospital at Gangdong Department of Obstetrics and Gynecology
이철민 ( Lee Chul-Min ) - Inje University College of Medicine Sanggye Paik Hospital Department of Obstetrics and Gynecology
최철훈 ( Choi Chel-Hun ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Obstetrics and Gynecology

Abstract


Purpose: We aimed to develop and validate individual prognostic models in a large cohort of cervical cancer patients that were primarily treated with radical hysterectomy.

Materials and Methods: We analyzed 1,441 patients with early-stage cervical cancer treated between 2000 and 2008 from the Korean Gynecologic Oncology Group multi-institutional cohort: a train cohort (n=788) and a test cohort (n=653). Models predicting the risk for overall survival (OS), disease-free survival (DFS), lymphatic recurrence and hematogenous recurrence were developed using Cox analysis and stepwise backward selection and best-model options. The prognostic performance of each model was assessed in an independent patient cohort. Model-classified risk groups were compared to groups based on traditional risk factors.

Results: Independent risk factors for OS, DFS, lymphatic recurrence, and hematogenous recurrence were identified for prediction model development. Different combinations of risk factors were shown for each outcome with best predictive value. In train cohort, area under the curve (AUC) at 2 and 5 years were 0.842/0.836 for recurrence, and 0.939/0.882 for OS. When applied to a test cohort, the model also showed accurate prediction result (AUC at 2 and 5 years were 0.799/0.723 for recurrence, and 0.844/0.806 for OS, respectively). The Kaplan-Meier plot by proposed model-classified risk groups showed more distinctive survival differences between each risk group.

Conclusion: We developed prognostic models for OS, DFS, lymphatic and hematogenous recurrence in patients with early-stage cervical cancer. Combining weighted clinicopathologic factors, the proposed model can give more individualized predictions in clinical practice.

키워드

Disease-free survival; Prognostic factor; Prognoses; Survival analyses; Uterine cervical neoplasms
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