External validation of nomograms designed to predict lymphatic dissemination in patients with early-stage endometrioid endometrial cancer: a multicenter study

Am J Obstet Gynecol. 2015 Jan;212(1):56.e1-7. doi: 10.1016/j.ajog.2014.06.058. Epub 2014 Jun 28.

Abstract

Objective: The objective of the study was to externally validate and assess the robustness of 2 nomograms designed to predict the probability of lymphatic dissemination (LD) for patients with early-stage endometrioid endometrial cancer.

Study design: Using a prospective multicenter database, we assessed the discrimination, calibration, and clinical utility of 2 nomograms in patients with surgically treated early-stage endometrioid endometrial cancer.

Results: Among the 322 eligible patients identified, the overall LD rate was 9.9% (32 of 322). Predictive accuracy according to discrimination was 0.65 (95% confidence interval, 0.61-0.69) for the full nomogram and 0.71 (95% confidence interval, 0.68-0.74) for the alternative nomogram. The correspondence between observed recurrence rate and the nomogram predictions suggests a moderate calibration of the nomograms in the validation cohort.

Conclusion: The nomograms were externally validated and shown to be partly generalizable to a new and independent patient population. Although these tools provide a more individualized estimation of LD, additional parameters are needed to allow higher accuracy for counseling patients in clinical practice.

Keywords: endometrial cancer; lymphatic dissemination; nomogram; validation.

Publication types

  • Multicenter Study
  • Validation Study

MeSH terms

  • Carcinoma, Endometrioid / secondary*
  • Endometrial Neoplasms / pathology*
  • Female
  • Humans
  • Lymphatic Metastasis*
  • Middle Aged
  • Neoplasm Staging
  • Nomograms*
  • Prospective Studies