Nomograms Predict Locally Advanced Cervical Cancer Recurrence, Patient Survival
Newly validated nomograms were more prognostic of patient survival from cervical cancer than cancer stage.
A retrospective data analysis of more than 2,000 patients with locally advanced cervical carcinoma, finds that tumor and patient factors can predict pelvic tumor recurrence and patient survival.
The data were used to develop and validate new prognostic nomograms that might improve individualization of patient treatments. They are just the latest such models in a growing prognostic toolkit for oncologists.
Several factors are associated with tumor recurrence risk and survival among patients diagnosed with cancer.
Research teams around the world are developing cancer-specific nomograms—algorithms that use these predictive factors to better identify patient prognosis and, therefore, to help with risk-stratification and the individualization of a patient's treatment plan.1,2
A 2013 paper by South Korean researchers, for example, proposed a survival-predicting nomogram for patients with cervical cancer based on tumor histology, tumor size, and para-aortic lymph node metastasis.3
Among the 209 patients studied, that nomogram was more predictive of patient survival than was Federation of Gynecology and Obstetrics (FIGO) stage.3
Now, a much larger study that retrospectively analyzed prognostic factors among 2,042 patients with locally advanced cervical carcinoma limited to the pelvis has yielded pelvic recurrence- and patient survival-predicting nomograms based on tumor size, grade, and FIGO stage; pelvic node status; performance status; ethnicity; and treatment with radiotherapy-concurrent cisplatin-based chemotherapy.1
The team's nomograms predicted 2-year progression-free survival (PFS), 5-year overall survival (OS), and pelvic recurrence.1 Patients with pelvic para-aortic lymph node involvement were excluded from the study.
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“Our multivariable analysis identified numerous prognostic factors that affect PFS and OS in locally advanced cervical cancer primarily treated with radiation therapy,” reported lead study author Peter C. Rose, of the Cleveland Clinic Foundation and Case Western Research University in Cleveland, OH, and coauthors.1
“We found that clinical stage, tumor size, pelvic node status, and performance status were significantly associated with PFS and OS.”
In contrast to previous research, patient age was not associated with recurrence or survival.1
“These nomograms can be used to better estimate individual and collective outcomes,” the coauthors concluded.1