Preoperative CT-based nomogram for predicting overall survival in women with non-endometrioid carcinomas of the uterine corpus Journal Article

Authors: Lakhman, Y.; Yakar, D.; Goldman, D. A.; Katz, S. S.; Vargas, H. A.; Miccò, M; Zheng, J.; Moskowitz, C. S.; Soslow, R. A.; Hricak, H.; Abu-Rustum, N. R.; Sala, E.
Article Title: Preoperative CT-based nomogram for predicting overall survival in women with non-endometrioid carcinomas of the uterine corpus
Abstract: Purpose: To develop a preoperative CT-based nomogram for predicting overall survival (OS) in patients with non-endometrioid carcinomas of the uterine corpus. Methods: Waiving informed consent, the institutional review board approved this HIPAA-compliant, retrospective study of 193 women with histopathologically proven uterine papillary serous carcinomas (UPSC), uterine clear cell carcinomas (UCCC), and uterine carcinosarcomas (UCS) who underwent primary surgical resection between May 1998 and December 2011, and had a preoperative CT ≤ 6 weeks before surgery. All CT scans were reviewed for local or/and regional tumor extent, presence of pelvic or/and para-aortic adenopathy, and presence of distant metastases. Univariate survival analysis was performed using log-rank test and Cox regression. Variables shown significant by the univariate analysis were evaluated with the multivariable Cox regression analysis and the results were used to create a nomogram for predicting OS. The predictive accuracy of the nomogram was assessed with the concordance probability index (c-index) and a 3-year calibration plot. Results: Mean patient age was 67.2 years (range 49.0–85.9); histologies included UPSC (n = 116), UCCC (n = 27), and UCS (n = 50). Median follow-up was 38.1 months (0.9–168.5 months). At multivariate analysis, patient age, ascites, and omental implants on CT were significant adverse predictors of OS and were used to build the nomogram. Concordance index for the nomogram was 0.640 ± 0.028. Conclusion: We developed a nomogram with a good concordance probability at predicting OS based on readily available pretreatment clinical and imaging characteristics. This preoperative nomogram has the potential to improve initial treatment planning and patient counseling. © 2014, Springer Science+Business Media New York.
Keywords: adult; cancer survival; aged; cancer surgery; survival rate; major clinical study; overall survival; histopathology; ascites; multimodality cancer therapy; adjuvant therapy; cancer adjuvant therapy; cancer patient; cancer radiotherapy; follow up; antineoplastic agent; endometrium carcinoma; preoperative evaluation; tumor localization; computer assisted tomography; medical record review; retrospective study; age; clear cell carcinoma; informed consent; nomogram; ct; lymphadenopathy; uterus; uterus sarcoma; predictive value; uterus carcinoma; carcinosarcoma; surgical patient; computed tomography scanner; institutional review; uterine carcinosarcoma; cancer prognosis; uterine clear cell carcinoma; human; female; priority journal; article; imaging software; non-endometrioid carcinoma; nonionic contrast medium; digestive implant; omental implant; paraaortic lymphadenopathy; pelvic lymphadenopathy
Journal Title: Abdominal Imaging
Volume: 40
Issue: 6
ISSN: 0942-8925
Publisher: Springer  
Date Published: 2015-08-01
Start Page: 1761
End Page: 1768
Language: English
DOI: 10.1007/s00261-014-0337-0
PROVIDER: scopus
PUBMED: 25549782
PMCID: PMC4965166
Notes: Export Date: 2 September 2015 -- Source: Scopus
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MSK Authors
  1. Yuliya Lakhman
    34 Lakhman
  2. Junting Zheng
    133 Zheng
  3. Evis Sala
    95 Sala
  4. Seth Stephen Katz
    16 Katz
  5. Chaya S. Moskowitz
    173 Moskowitz
  6. Robert Soslow
    644 Soslow
  7. Hedvig Hricak
    333 Hricak
  8. Debra Alyssa Goldman
    97 Goldman
  9. Maura Micco
    10 Micco
  10. Derya   Yakar
    4 Yakar