A Web- Based Nomogram Predicting Para- aortic Nodal Metastasis in Incompletely Staged Patients With Endometrial Cancer
- Authors
- Kang, Sokbom; Lee, Jong-Min; Lee, Jae-Kwan; Kim, Jae-Weon; Cho, Chi-Heum; Kim, Seok-Mo; Park, Sang-Yoon; Park, Chan-Yong; Kim, Ki-Tae
- Issue Date
- 3월-2014
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Keywords
- Endometrial cancer; Lymph node; Lymphadenectomy; Metastasis; Para-aortic; Staging
- Citation
- INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER, v.24, no.3, pp.513 - 519
- Indexed
- SCIE
SCOPUS
- Journal Title
- INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER
- Volume
- 24
- Number
- 3
- Start Page
- 513
- End Page
- 519
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/99119
- DOI
- 10.1097/IGC.0000000000000090
- ISSN
- 1048-891X
- Abstract
- Objective The purpose of this study is to develop a Web-based nomogram for predicting the individualized risk of para-aortic nodal metastasis in incompletely staged patients with endometrial cancer. Methods From 8 institutions, the medical records of 397 patients who underwent pelvic and para-aortic lymphadenectomy as a surgical staging procedure were retrospectively reviewed. A multivariate logistic regression model was created and internally validated by rigorous bootstrap resampling methods. Finally, the model was transformed into a user-friendly Web-based nomogram (http://www.kgog.org/nomogram/empa001.html). Results The rate of para-aortic nodal metastasis was 14.4% (57/397 patients). Using a stepwise variable selection, 4 variables including deep myometrial invasion, non-endometrioid subtype, lymphovascular space invasion, and log-transformed CA-125 levels were finally adopted. After 1000 repetitions of bootstrapping, all of these 4 variables retained a significant association with para-aortic nodal metastasis in the multivariate analysisdeep myometrial invasion (P = 0.001), non-endometrioid histologic subtype (P = 0.034), lymphovascular space invasion (P = 0.003), and log-transformed serum CA-125 levels (P = 0.004). The model showed good discrimination (C statistics = 0.87; 95% confidence interval, 0.82-0.92) and accurate calibration (Hosmer-Lemeshow P = 0.74). Conclusions This nomogram showed good performance in predicting para-aortic metastasis in patients with endometrial cancer. The tool may be useful in determining the extent of lymphadenectomy after incomplete surgery.
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Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
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