An external validation study of nomograms designed to predict isolated loco-regional and distant endometrial cancer recurrences: how applicable are they?

• Published in: British journal of cancer Vol. 109; no. 6; pp. 1498 - 1503
• Main Authors: Bendifallah, S, Canlorbe, G, Raimond, E, Bazire, L, Huguet, F, Graesslin, O, Rouzier, R, Darai, E, Ballester, M
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 17-09-2013; Nature Publishing Group
• Subjects: 692/699/67/1517/1931; 692/700/139; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Calibration; Cancer Research; Cancer therapies; Cellular biology; Clinical Study; Cohort Studies; Drug Resistance; Endometrial cancer; Endometrial Neoplasms - pathology; Epidemiology; Female; Female genital diseases; Gynecology; Gynecology. Andrology. Obstetrics; Hospitals; Humans; Medical sciences; Middle Aged; Molecular Medicine; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Neoplasm Recurrence, Local - pathology; Nomograms; Obstetrics; Oncology; Patients; Predictive Value of Tests; Surgery; Tumors; Validation studies; France; Paris France; recurrence; endometrial cancer; nomogram; validation; Validation; Endometrium cancer; Relapse; Nomogram; Prediction; Malignant tumor; Regional; Female genital diseases; Cancerology; Uterine diseases; External; Predictive factor; Cancer
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/bjc.2013.500

Background:
To externally validate and assess the robustness of two nomograms to predict the recurrence risk of women with endometrial cancer (EC).
Methods:
Using an independent, multicentre external patient cohort we assessed the discrimination and calibration of two nomograms – the 3-year isolated loco-regional (ILRR) and distant (DR) recurrence nomograms – in women with surgically treated stage I–III EC.
Results:
Two hundred and seventy one eligible women were identified from two university hospital databases and the Senti-Endo trial. The median follow-up and initial recurrence time were 38.1 (range: 12–69) and 22.0 (range: 8.3–55) months, respectively. The overall recurrence rate was 13.8% (37 out of 271). Predictive accuracy according to the discrimination was 0.69 (95% CI, 0.58–0.79) and 0.66 (95% CI, 0.60–0.71) for the 3-year ILRR and DR nomograms, respectively. 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 generalisable to a new and independent patient population. The tools need to be improved by including information on the lymph node status and adjuvant therapies.