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Abdominal Imaging

, Volume 40, Issue 6, pp 1761–1768 | Cite as

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

  • Yulia LakhmanEmail author
  • Derya Yakar
  • Debra A. Goldman
  • Seth S. Katz
  • Hebert A. Vargas
  • Maura Miccò
  • Junting Zheng
  • Chaya S. Moskowitz
  • Robert A. Soslow
  • Hedvig Hricak
  • Nadeem R. Abu-Rustum
  • Evis Sala
Article

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.

Keywords

Nomogram CT Non-endometrioid carcinoma Uterus 

Notes

Conflict of interest

There are no conflicts to disclose.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Yulia Lakhman
    • 1
    Email author
  • Derya Yakar
    • 1
    • 2
  • Debra A. Goldman
    • 3
  • Seth S. Katz
    • 1
  • Hebert A. Vargas
    • 1
  • Maura Miccò
    • 1
    • 4
  • Junting Zheng
    • 3
  • Chaya S. Moskowitz
    • 3
  • Robert A. Soslow
    • 5
  • Hedvig Hricak
    • 1
  • Nadeem R. Abu-Rustum
    • 6
  • Evis Sala
    • 1
  1. 1.Department of RadiologyMemorial Sloan Kettering Cancer CenterNew YorkUSA
  2. 2.Department of RadiologyRadboud University Nijmegen Medical CenterNijmegenThe Netherlands
  3. 3.Department of Epidemiology and BiostatisticsMemorial Sloan Kettering Cancer CenterNew YorkUSA
  4. 4.Department of Bioimaging and Radiological ScienceCatholic University “A. Gemelli” HospitalRomeItaly
  5. 5.Department of PathologyMemorial Sloan Kettering Cancer CenterNew YorkUSA
  6. 6.Gynecologic Service, Department of SurgeryMemorial Sloan Kettering Cancer CenterNew YorkUSA

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