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

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A Commentary to this article was published on 29 January 2016

An Editor Note to this article was published on 22 January 2016

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.

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Conflict of interest

There are no conflicts to disclose.

Author information

Author notes

  1. Derya Yakar

    Present address: Department of Radiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands

  2. Maura Miccò

    Present address: Department of Bioimaging and Radiological Science, Catholic University “A. Gemelli” Hospital, Rome, Italy

Authors and Affiliations

  1. Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, USA

    Yulia Lakhman, Derya Yakar, Seth S. Katz, Hebert A. Vargas, Maura Miccò, Hedvig Hricak & Evis Sala

  2. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, USA

    Debra A. Goldman, Junting Zheng & Chaya S. Moskowitz

  3. Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA

    Robert A. Soslow

  4. Gynecologic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA

    Nadeem R. Abu-Rustum

Authors
  1. Yulia Lakhman
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  2. Derya Yakar
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  3. Debra A. Goldman
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  4. Seth S. Katz
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  10. Hedvig Hricak
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  12. Evis Sala
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Corresponding author

Correspondence to Yulia Lakhman.

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Lakhman, Y., Yakar, D., Goldman, D.A. et al. Preoperative CT-based nomogram for predicting overall survival in women with non-endometrioid carcinomas of the uterine corpus. Abdom Imaging 40, 1761–1768 (2015). https://doi.org/10.1007/s00261-014-0337-0

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  • DOI: https://doi.org/10.1007/s00261-014-0337-0

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