TY - JOUR
T1 - Evaluation of models to predict lymph node metastasis in endometrial cancer: A multicentre study
AU - Koskas, Martin
AU - Fournier, Marie
AU - Vanderstraeten, Anke
AU - Walker, Francine
AU - Timmerman, Dirk
AU - Vergote, Ignace
AU - Amant, Frédéric
PY - 2016
Y1 - 2016
N2 - Background: Several models (preoperative and postoperative) have been developed to predict lymph node metastasis (LNM) in patients with endometrial cancer. The purpose of our investigation was to compare available models in a multicentre study. Methods: In a cohort of 519 patients with endometrial cancer who had undergone primary hysterectomy and at least a pelvic lymphadenectomy, we compared the areas under the receiver-operating characteristic curves (AUCs), calibrations, rates of false negatives (FN), and the number of patients at low-risk for LNM using ten different models (three preoperative and seven postoperative). Results: In all, 17.5% of patients among the study population (91 in 519) had LNM. Only one of the three preoperative models and three of the seven postoperative models had an AUC > 0.75. Six models were well calibrated. Eight models yielded an FN rate of <5%. Six models could assign more than a third of patients to the low-risk group. One postoperative (a French nomogram) and one preoperative (the Korean Gynecologic Oncology Group [KGOG]) model had an AUC >0.75, to yield an FN rate of <5%, and could assign more than a third of patients to the low-risk group. Conclusions: This study supports the use of the KGOG model to decide upon lymphadenectomy preoperatively in patients with endometrial cancer. For patients who did not have lymphadenectomy, a French nomogram could be applied using pathological characteristics to decide on a secondary lymphadenectomy. (C) 2016 Elsevier Ltd. All rights reserved
AB - Background: Several models (preoperative and postoperative) have been developed to predict lymph node metastasis (LNM) in patients with endometrial cancer. The purpose of our investigation was to compare available models in a multicentre study. Methods: In a cohort of 519 patients with endometrial cancer who had undergone primary hysterectomy and at least a pelvic lymphadenectomy, we compared the areas under the receiver-operating characteristic curves (AUCs), calibrations, rates of false negatives (FN), and the number of patients at low-risk for LNM using ten different models (three preoperative and seven postoperative). Results: In all, 17.5% of patients among the study population (91 in 519) had LNM. Only one of the three preoperative models and three of the seven postoperative models had an AUC > 0.75. Six models were well calibrated. Eight models yielded an FN rate of <5%. Six models could assign more than a third of patients to the low-risk group. One postoperative (a French nomogram) and one preoperative (the Korean Gynecologic Oncology Group [KGOG]) model had an AUC >0.75, to yield an FN rate of <5%, and could assign more than a third of patients to the low-risk group. Conclusions: This study supports the use of the KGOG model to decide upon lymphadenectomy preoperatively in patients with endometrial cancer. For patients who did not have lymphadenectomy, a French nomogram could be applied using pathological characteristics to decide on a secondary lymphadenectomy. (C) 2016 Elsevier Ltd. All rights reserved
U2 - https://doi.org/10.1016/j.ejca.2016.03.079
DO - https://doi.org/10.1016/j.ejca.2016.03.079
M3 - Article
C2 - 27153472
SN - 0959-8049
VL - 61
SP - 52
EP - 60
JO - European journal of cancer (Oxford, England
JF - European journal of cancer (Oxford, England
ER -