کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6183210 1254095 2015 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Nomogram for predicting incomplete cytoreduction in advanced ovarian cancer patients
ترجمه فارسی عنوان
نوموگرام برای پیش بینی تزریق ناکامل در بیماران مبتلا به سرطان پیشرفته تخمدان
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی زنان، زایمان و بهداشت زنان
چکیده انگلیسی


- 343 consecutive advanced-ovarian cancer patients undergoing PET/CT before primary surgery were analyzed.
- Using surgical aggressiveness and PET/CT features, a nomogram for predicting incomplete cytoreduction was developed.
- Nomogram performance was good across individual surgeons of heterogeneous surgical aggressiveness.

ObjectiveAccurately predicting cytoreducibility in advanced-ovarian cancer is needed to establish preoperative plans, consider neoadjuvant chemotherapy, and improve clinical trial protocols. We aimed to develop a positron-emission tomography/computed tomography-based nomogram for predicting incomplete cytoreduction in advanced-ovarian cancer patients.MethodsBetween 2006 and 2012, 343 consecutive advanced-ovarian cancer patients underwent positron-emission tomography/computed tomography before primary cytoreduction: 240 and 103 patients were assigned to the model development or validation cohort, respectively. After reviewing the detailed surgical documentation, incomplete cytoreduction was defined as a remaining gross residual tumor. We evaluated each individual surgeon's surgical aggressiveness index (number of high-complex surgeries/total number of surgeries). Possible predictors, including surgical aggressiveness index and positron-emission tomography/computed tomography features, were analyzed using logistic regression modeling. A nomogram based on this model was developed and externally validated.ResultsComplete cytoreduction was achieved in 120 patients (35%). Surgical aggressiveness index and five positron-emission tomography/computed tomography features were independent predictors of incomplete cytoreduction. Our nomogram predicted incomplete cytoreduction by incorporating these variables and demonstrated good predictive accuracy (concordance index = 0.881; 95% CI = 0.838-0.923). The predictive accuracy of our validation cohort was also good (concordance index = 0.881; 95% CI = 0.790-0.932) and the predicted probability was close to the actual observed outcome. Our model demonstrated good performance across surgeons with varying degrees of surgical aggressiveness.ConclusionWe have developed and validated a nomogram for predicting incomplete cytoreduction in advanced-ovarian cancer patients which may help stratify patients for clinical trials, establish meticulous preoperative plans, and determine if neoadjuvant chemotherapy is warranted.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Gynecologic Oncology - Volume 136, Issue 1, January 2015, Pages 30-36
نویسندگان
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