Abstract
Background: This study constructed and demonstrated a model to predict the overall survival (OS) of newly diagnosed distant metastatic cervical cancer (mCC) patients.Methods: The SEER (Surveillance, Epidemiology, and End Results) database was used to collect the eligible data, which from 2010 to 2016. Then these data were separated into training and validation cohorts (7:3) randomly. Cox regression analyses was used to identify parameters significantly correlated with OS. Harrell's Concordance index (C-index), calibration curves, and decision curve analysis (DCA) were further applied to verify the performance of this model.Results: A total of 2,091 eligible patients were enrolled and randomly split into training (n = 1,467) and validation (n = 624) cohorts. Multivariate analyses revealed that age, histology, T stage, tumor size, metastatic sites, local surgery, chemotherapy, and radiotherapy were independent prognostic parameters and were then used to build a nomogram for predicting 1 and 2-year OS. The C-index of training group and validation group was 0.714 and 0.707, respectively. The calibration curve demonstrated that the actual observation was in good agreement with the predicted results concluded by the nomogram model. Its clinical usefulness was further revealed by the DCAs. Based on the scores from the nomogram, a corresponding risk classification system was constructed. In the overall population, the median OS time was 23.0 months (95% confidence interval [CI], 20.5–25.5), 12.0 months (95% CI, 11.1–12.9), and 5.0 months (95% CI, 4.4–5.6), in the low-risk group, intermediate-risk group, and high-risk group, respectively.Conclusion: A novel nomogram and a risk classification system were established in this study, which purposed to predict the OS time with mCC patients. These tools could be applied to prognostic analysis and should be validated in future studies.
Highlights
Cervix uteri carcinoma is the fourth most common gynecological cancer in the world, with an estimated 569,847 new cases and 311,365 deaths in 2018 [1, 2]
For metastatic cervical cancer (mCC) patients diagnosed with hematogenous dissemination to the pulmonary system after curative initial treatment, a previous study demonstrated that the 5-year disease-free survival rate after pulmonary metastasectomy was 32.9% [7]
Eligible data was obtained according to the following criteria: [1] pathological diagnosis of cervical uterine carcinoma by morphological code C53.9 between 2010 and 2016; [2] a primary diagnosis of cervical uterine carcinoma; and [3] IVB diseases diagnosed according to the 7th edition criteria of the TNM classification of malignant tumors and SEER Combined Stage (2016+)
Summary
Cervix uteri carcinoma is the fourth most common gynecological cancer in the world, with an estimated 569,847 new cases and 311,365 deaths in 2018 [1, 2]. The human papillomavirus (HPV) vaccine and cervical cytological screening have decreased the morbidity of cervical uterine carcinoma, distant metastatic cervical carcinoma (mCC, stage IVB) remains a major cause of cancer-related death among women globally. The Gynecologic Oncology Group 204 trial had shown that the bevacizumab combination with chemotherapy (CT) could prolong the OS over 12 months for metastatic, persistent, or recurrent cervical uterine carcinoma [4], the prognosis of mCC patients remains poor and most patients still adopt palliative treatment at present. For mCC patients diagnosed with hematogenous dissemination to the pulmonary system after curative initial treatment, a previous study demonstrated that the 5-year disease-free survival rate after pulmonary metastasectomy was 32.9% [7]. This study constructed and demonstrated a model to predict the overall survival (OS) of newly diagnosed distant metastatic cervical cancer (mCC) patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
