Establishment and Verification of the Nomogram That Predicts the 3-year Recurrence Risk of Epithelial Ovarian Carcinoma

Abstract Background As we all know, patients with epithelial ovarian carcinoma have poor prognosis and high recurrence rate. It is critical and challenging to screen out the patients with high risk of recurrence. At present, there are some models predicting the overall survival of epithelial ovarian carcinoma, however, there is no widely accepted tool or applicable model predicting the recurrence risk of epithelial ovarian carcinoma patients. The objective of this study was to establish and verify a nomogram to predict the recurrence risk of EOC. Methods We reviewed the clinicopathological and prognostic data of 193 patients with EOC who achieved clinical complete remission after cytoreductive surgery and chemotherapy between January 2003 and December 2013 in Peking University First Hospital. The nomogram was established with the risk factors selected by LASSO regression. The medical data of 187 EOC patients with 5-year standard follow-up in Peking University Third Hospital and Beijing Obstetrics and Gynecology Hospital were used for external validation of the nomogram. AUC curve and Hosmer-Lemeshow test were used to evaluate the discrimination and calibration.Results The nomogram for 3-year recurrence risk was established with FIGO stage, histological grade, histological type, lymph node metastasis status and serum CA125 level at diagnosis. The total score can be obtained by adding the grading values of these factors together. In the external validation, the AUC (C statistics) was 0.803 [95%CI, 0.738-0.867] and the Chi-square value is 11.04 (P=0.135>0.05). With the threshold value of 198, the sensitivity, specificity, positive predictive value, negative predictive value and correct index of the monogram were 75.7%, 77.0%, 83.2%, 67.9%, and 0.52 respectively.Conclusions We established and validated a nomogram to predict 3-year recurrence risk of patients with EOC who achieved clinical complete remission after cytoreductive surgery and chemotherapy. This nomogram with good discrimination and calibration might be useful for screening out the patients with high risk of recurrence.Precis: Establishment and verification of the nomogram predicting the 3-year recurrence risk of EOC

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Establishment and verification of the nomogram that predicts the 3-year recurrence risk of epithelial ovarian carcinoma

10.21203/rs.3.rs-37395/v1 ◽

2020 ◽

Author(s):

君胡 ◽

Xiaobing Jiao ◽

Lirong Zhu ◽

Hongyan Guo ◽

Yumei Wu

Keyword(s):

High Risk ◽

Ovarian Carcinoma ◽

Predictive Value ◽

Histological Grade ◽

External Validation ◽

Recurrence Risk ◽

Figo Stage ◽

Epithelial Ovarian Carcinoma ◽

High Recurrence Rate ◽

Risk Of Recurrence

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Establishment and verification of the nomogram that predicts the 3-year recurrence risk of epithelial ovarian carcinoma

BMC Cancer ◽

10.1186/s12885-020-07402-2 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Jun Hu ◽

Xiaobing Jiao ◽

Lirong Zhu ◽

Hongyan Guo ◽

Yumei Wu

Keyword(s):

Ovarian Carcinoma ◽

Predictive Value ◽

External Validation ◽

Threshold Value ◽

Recurrence Risk ◽

Epithelial Ovarian Carcinoma ◽

Concordance Index ◽

Chi Square ◽

Peking University ◽

Sensitivity Specificity

Abstract Background As we all know, patients with epithelial ovarian carcinoma have poor prognosis and high recurrence rate. It is critical and challenging to screen out the patients with high risk of recurrence. At present, there are some models predicting the overall survival of epithelial ovarian carcinoma, however, there is no widely accepted tool or applicable model predicting the recurrence risk of epithelial ovarian carcinoma patients. The objective of this study was to establish and verify a nomogram to predict the recurrence risk of EOC. Methods We reviewed the clinicopathological and prognostic data of 193 patients with EOC who achieved clinical complete remission after cytoreductive surgery and chemotherapy between January 2003 and December 2013 in Peking University First Hospital. The nomogram was established with the risk factors selected by LASSO regression. The medical data of 187 EOC patients with 5-year standard follow-up in Peking University Third Hospital and Beijing Obstetrics and Gynecology Hospital were used for external validation of the nomogram. AUC curve and Hosmer-Lemeshow test were used to evaluate the discrimination and calibration. Results The nomogram for 3-year recurrence risk was established with FIGO stage, histological grade, histological type, lymph node metastasis status and serum CA125 level at diagnosis. The total score can be obtained by adding the grading values of these factors together. The C statistics was 0.828 [95% CI, 0.764–0.884] and the Chi-square value is 3.6 (P = 0.731 > 0.05) with the training group. When the threshold value was set at 198, the sensitivity, specificity, positive predictive value, negative predictive value and concordance index were 88.8, 67.0, 71.8, 86.3% and 0.558 respectively. In the external validation, the C statistics was 0.803 [95%CI, 0.738–0.867] and the Chi-square value is 11.04 (P = 0.135 > 0.05). With the threshold value of 198, the sensitivity, specificity, positive predictive value, negative predictive value and concordance index of the nomogram were 75.7, 77.0, 83.2, 67.9%, and 0.52 respectively. Conclusions We established and validated a nomogram to predict 3-year recurrence risk of patients with EOC who achieved clinical complete remission after cytoreductive surgery and chemotherapy. This nomogram with good discrimination and calibration might be useful for screening out the patients with high risk of recurrence.

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Establishment and verification of the nomogram that predicts the 3-year recurrence risk of epithelial ovarian carcinoma

10.21203/rs.3.rs-41532/v3 ◽

2020 ◽

Author(s):

Jun Hu ◽

Xiaobing Jiao ◽

Lirong Zhu ◽

Hongyan Guo ◽

Yumei Wu

Keyword(s):

Ovarian Carcinoma ◽

Predictive Value ◽

External Validation ◽

Threshold Value ◽

Recurrence Risk ◽

Epithelial Ovarian Carcinoma ◽

Concordance Index ◽

Chi Square ◽

Peking University ◽

Sensitivity Specificity

Abstract Background As we all know, patients with epithelial ovarian carcinoma have poor prognosis and high recurrence rate. It is critical and challenging to screen out the patients with high risk of recurrence. At present, there are some models predicting the overall survival of epithelial ovarian carcinoma, however, there is no widely accepted tool or applicable model predicting the recurrence risk of epithelial ovarian carcinoma patients. The objective of this study was to establish and verify a nomogram to predict the recurrence risk of EOC. Methods We reviewed the clinicopathological and prognostic data of 193 patients with EOC who achieved clinical complete remission after cytoreductive surgery and chemotherapy between January 2003 and December 2013 in Peking University First Hospital. The nomogram was established with the risk factors selected by LASSO regression. The medical data of 187 EOC patients with 5-year standard follow-up in Peking University Third Hospital and Beijing Obstetrics and Gynecology Hospital were used for external validation of the nomogram. AUC curve and Hosmer-Lemeshow test were used to evaluate the discrimination and calibration.Results The nomogram for 3-year recurrence risk was established with FIGO stage, histological grade, histological type, lymph node metastasis status and serum CA125 level at diagnosis. The total score can be obtained by adding the grading values of these factors together. The C statistics was 0.828 [95% CI, 0.764-0.884] and the Chi-square value is 3.6 (P=0.731>0.05) with the training group. When the threshold value was set at 198, the sensitivity, specificity, positive predictive value, negative predictive value and concordance index were 88.8%, 67.0%, 71.8%, 86.3% and 0.558 respectively. In the external validation, the C statistics was 0.803 [95%CI, 0.738-0.867] and the Chi-square value is 11.04 (P=0.135>0.05). With the threshold value of 198, the sensitivity, specificity, positive predictive value, negative predictive value and concordance index of the nomogram were 75.7%, 77.0%, 83.2%, 67.9%, and 0.52 respectively.Conclusions We established and validated a nomogram to predict 3-year recurrence risk of patients with EOC who achieved clinical complete remission after cytoreductive surgery and chemotherapy. This nomogram with good discrimination and calibration might be useful for screening out the patients with high risk of recurrence.

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Establishment and verification of the nomogram that predicts the 3-year recurrence risk of epithelial ovarian carcinoma

10.21203/rs.3.rs-41532/v2 ◽

2020 ◽

Author(s):

Jun Hu ◽

Xiaobing Jiao ◽

Lirong Zhu ◽

Hongyan Guo ◽

Yumei Wu

Keyword(s):

Ovarian Carcinoma ◽

Predictive Value ◽

External Validation ◽

Threshold Value ◽

Recurrence Risk ◽

Epithelial Ovarian Carcinoma ◽

Concordance Index ◽

Chi Square ◽

Peking University ◽

Sensitivity Specificity

Abstract Background As we all know, patients with epithelial ovarian carcinoma have poor prognosis and high recurrence rate. It is critical and challenging to screen out the patients with high risk of recurrence. At present, there are some models predicting the overall survival of epithelial ovarian carcinoma, however, there is no widely accepted tool or applicable model predicting the recurrence risk of epithelial ovarian carcinoma patients. The objective of this study was to establish and verify a nomogram to predict the recurrence risk of EOC.Methods We reviewed the clinicopathological and prognostic data of 193 patients with EOC who achieved clinical complete remission after cytoreductive surgery and chemotherapy between January 2003 and December 2013 in Peking University First Hospital. The nomogram was established with the risk factors selected by LASSO regression. The medical data of 187 EOC patients with 5-year standard follow-up in Peking University Third Hospital and Beijing Obstetrics and Gynecology Hospital were used for external validation of the nomogram. AUC curve and Hosmer-Lemeshow test were used to evaluate the discrimination and calibration.Results The nomogram for 3-year recurrence risk was established with FIGO stage, histological grade, histological type, lymph node metastasis status and serum CA125 level at diagnosis. The total score can be obtained by adding the grading values of these factors together. The C statistics was 0.828 [95% CI, 0.764-0.884] and the Chi-square value is 3.6 (P=0.731>0.05) with the training group. When the threshold value was set at 198, the sensitivity, specificity, positive predictive value, negative predictive value and concordance index were 88.8%, 67.0%, 71.8%, 86.3% and 0.558 respectively. In the external validation, the C statistics was 0.803 [95%CI, 0.738-0.867] and the Chi-square value is 11.04 (P=0.135>0.05). With the threshold value of 198, the sensitivity, specificity, positive predictive value, negative predictive value and concordance index of the nomogram were 75.7%, 77.0%, 83.2%, 67.9%, and 0.52 respectively.Conclusions We established and validated a nomogram to predict 3-year recurrence risk of patients with EOC who achieved clinical complete remission after cytoreductive surgery and chemotherapy. This nomogram with good discrimination and calibration might be useful for screening out the patients with high risk of recurrence.

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Preoperative abdominopelvic computed tomographic prediction of optimal cytoreduction in epithelial ovarian carcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.1993.11.1.166 ◽

1993 ◽

Vol 11 (1) ◽

pp. 166-172 ◽

Cited By ~ 175

Author(s):

B E Nelson ◽

A T Rosenfield ◽

P E Schwartz

Keyword(s):

Ovarian Carcinoma ◽

Primary Tumor ◽

Predictive Value ◽

Surgical Outcome ◽

Residual Disease ◽

Epithelial Ovarian Carcinoma ◽

Optimal Cytoreduction ◽

Histologic Diagnosis ◽

Ct Findings ◽

Gallbladder Fossa

PURPOSE This study was undertaken to assess the ability of computed tomography (CT) to predict the likelihood of optimal primary tumor cytoreduction in women with epithelial ovarian carcinoma. PATIENTS AND METHODS Fifty-one women with preoperative CT and a histologic diagnosis of epithelial ovarian carcinoma following primary tumor operation by a gynecologic oncologist were identified. Forty-two CT scans were retrospectively analyzed. CT findings of attachment of the omentum to the spleen or disease greater than 2 cm on the diaphragm, liver surface, or parenchyma, pleura, mesentery, gallbladder fossa, or suprarenal paraaortic nodes were coded to represent unresectable disease. CT results were compared with surgical outcome. RESULTS Twenty-nine of 42 (69%) patients underwent optimal cytoreduction to less than 2 cm residual disease. Successful cytoreduction was accomplished in 23 of 24 patients who fulfilled CT criteria for cytoreduction and six of 18 with CT criteria predictive of inability to perform cytoreduction. CT was highly sensitive for detection of ascites, mesenteric, and omental disease, but was poor for detection of liver involvement, omental attachment to the spleen, gallbladder fossa disease, and peritoneal nodules smaller than 2 cm. The CT findings accurately predicted surgical outcome with a sensitivity of 92.3% and specificity of 79.3%. The positive predictive value was 67% and the negative predictive value was 96%. CONCLUSION CT scan is an accurate method for the prediction of successful surgical cytoreduction and may have utility in the decision to offer neoadjuvant chemotherapy to certain medically disabled patients, a hypothesis currently under evaluation.

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Predictive value of changes in the serum CA-125 levels in patients undergoing interval debulking surgery after neoadjuvant chemotherapy in advanced epithelial ovarian carcinoma

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20190272 ◽

2019 ◽

Vol 8 (2) ◽

pp. 483

Author(s):

Sonia Batra ◽

Ruchi Arora ◽

Kalpana Dave

Keyword(s):

Neoadjuvant Chemotherapy ◽

Ovarian Carcinoma ◽

Predictive Value ◽

Epithelial Ovarian Carcinoma ◽

Ca 125 ◽

Optimal Cytoreduction ◽

Normal Range ◽

Debulking Surgery ◽

Ovarian Cancers ◽

Interval Debulking Surgery

Background: The objective of this study is to evaluate the predictive value of serum CA-125 changes in the management of patients undergoing neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) in advanced epithelial ovarian carcinoma (EOC).Methods: A retrospective hospital-based study of patients with advanced epithelial ovarian cancers (stage III and IV) was conducted at Department of Obstetrics and Gynecology in Gujarat Cancer and Research Institute, Ahmedabad, for two years. Total 50 patients were treated with NACT followed by surgical cytoreduction and followed up till August 2010. Response to NACT, optimal cytoreduction rate and overall response rate were analyzed.CA 125 levels before (baseline) and after NACT were analyzed.Results: Out of 50, there were 43 patients (86%) with stage III disease and 7 (14%) with stage IV disease. Maximum 37(74%) patients had CA 125 levels >500 on presentation while none of the patients had baseline CA125 levels in the normal range (<35). Range of baseline CA 125 was 164-5394.All patients were given NACT and after NACT, out of 50 patients, 22(44%) patients had CA 125 values within the normal range (<35) while 23(46%) had values between 35 and 100. Thus, statistically significant difference (Z = 6.154, P<0.0001) was found between CA 125 level before and after NACT. Out of 45 patients with CA 125 <100, 35(77.8%) underwent optimal cytoreduction.Conclusions: Baseline (prechemotherapy) serum CA-125 levels are powerful indicators of the presence and extent of spread of disease while CA-125 level particularly <100U/ml after NACT strongly predicts optimal cytoreduction in advanced epithelial ovarian cancers.

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