Traditionally we have relied mainly on final FIGO stage to estimate overall oncologic outcome in endometrial cancer patients. However, it is well known that other patient factors may play equally important roles in outcome. Our objective was to develop a clinically useful nomogram in the hope of providing a more individualized and accurate estimation of overall survival (OS) following primary therapy.
Using a prospectively maintained endometrial cancer database, 1735 patients treated between 1993–2008 were analyzed. Clinical characteristics commonly known to predict OS were collected. For each patient, points were assigned to each of these 5 variables and a total score was calculated. The corresponding 3- and 5-year OS probabilities were then determined from the nomogram.
The median age was 62 years (range, 25–96). Final grade included: G1 (471), G2 (622), G3 (634), missing (8). Stage included: IA (501), IB (590), IC (141), IIA (36), IIB (75), IIIA (116), IIIB (6), IIIC (135), IVA (7), and IVB (128). Histology included: adenocarcinoma (1376), carcinosarcoma (100), clear cell (62), serous (197). Median follow-up for survivors was 29.2 months (0–162.2 months). Concordance probability estimator for the nomogram is 0.746 ± 0.011.
Using a large endometrial cancer database we developed a nomogram based on 5 easily available clinical characteristics to predict OS with a high concordance probability. This nomogram incorporates other important individualized patient variables beyond FIGO stage to more accurately predict outcome. This new tool may be useful to clinicians in assessing patients risk when deciding on adjuvant treatment and follow-up.
Keywords: Nomogram, endometrial cancer, staging, lymph nodes