Tsung-Hsin Yeh , Chen-Hsuan Wu , Yu-Che Ou , Hung-Chun Fu , Hao Lin
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A nomogram was constructed based on the significant predictors, and its performance was evaluated using calibration, discrimination, and validation analyses.</p></div><div><h3>Results</h3><p>Of the 210 patients, 139 (66.19%) had platinum-sensitive and 71 (33.81%) were platinum-resistant disease. On multivariate analysis, platinum-resistance correlated with neoadjuvant chemotherapy (OR 2.15; 95% CI 1.10–4.21), clear cell/mucinous histology (OR 5.04; 95% CI 2.20–11.54), and sub-optimal debulking status (OR 3.37; 95% CI 1.44–7.91). Median PFS and OS were also significantly shorter for patients with neoadjuvant chemotherapy (23 vs. 10 months and 69 vs. 29 months, respectively), clear cell/mucinous histology (15 vs. 3 months and 63 vs. 11 months, respectively), and suboptimal debulking (26 vs. 5 months and 78 vs. 24 months, respectively). The nomogram demonstrated good predictive accuracy for platinum-sensitivity in the cohort as indicated by high concordance index of 0.745. Calibration plots showed excellent agreement and internal validation further confirmed the reliability of the nomogram's performance.</p></div><div><h3>Conclusion</h3><p>A novel predictive nomogram based on type of initial treatment, histology, and debulking status was developed, which provides a friendly and reliable tool for predicting platinum-sensitivity and survival outcomes in women with advanced EOC. Its application may assist clinicians in individualizing treatment decisions.</p></div>","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"63 5","pages":"Pages 709-716"},"PeriodicalIF":2.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1028455924001803/pdfft?md5=a3e5a2590791578826d96b40cbd06b64&pid=1-s2.0-S1028455924001803-main.pdf","citationCount":"0","resultStr":"{\"title\":\"A nomogram to predict platinum-sensitivity and survival outcome in women with advanced epithelial ovarian cancer\",\"authors\":\"Tsung-Hsin Yeh , Chen-Hsuan Wu , Yu-Che Ou , Hung-Chun Fu , Hao Lin\",\"doi\":\"10.1016/j.tjog.2024.05.022\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>This study presents the development and validation of a nomogram aimed at predicting platinum-sensitivity and survival outcomes in women with advanced epithelial ovarian cancer (EOC).</p></div><div><h3>Materials and methods</h3><p>Data from a retrospective cohort of women diagnosed with stage III/IV EOC between Jan 2011 and Dec 2021 treated at our institute were collected. Clinical and pathological characteristics were analyzed using logistic regression analysis to identify independent predictors of platinum-sensitivity. Impact on progression-free (PFS) and overall survival (OS) was determined by Kaplan–Meier and Cox regression analysis. A nomogram was constructed based on the significant predictors, and its performance was evaluated using calibration, discrimination, and validation analyses.</p></div><div><h3>Results</h3><p>Of the 210 patients, 139 (66.19%) had platinum-sensitive and 71 (33.81%) were platinum-resistant disease. On multivariate analysis, platinum-resistance correlated with neoadjuvant chemotherapy (OR 2.15; 95% CI 1.10–4.21), clear cell/mucinous histology (OR 5.04; 95% CI 2.20–11.54), and sub-optimal debulking status (OR 3.37; 95% CI 1.44–7.91). Median PFS and OS were also significantly shorter for patients with neoadjuvant chemotherapy (23 vs. 10 months and 69 vs. 29 months, respectively), clear cell/mucinous histology (15 vs. 3 months and 63 vs. 11 months, respectively), and suboptimal debulking (26 vs. 5 months and 78 vs. 24 months, respectively). The nomogram demonstrated good predictive accuracy for platinum-sensitivity in the cohort as indicated by high concordance index of 0.745. Calibration plots showed excellent agreement and internal validation further confirmed the reliability of the nomogram's performance.</p></div><div><h3>Conclusion</h3><p>A novel predictive nomogram based on type of initial treatment, histology, and debulking status was developed, which provides a friendly and reliable tool for predicting platinum-sensitivity and survival outcomes in women with advanced EOC. 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引用次数: 0
摘要
材料和方法收集了2011年1月至2021年12月在我院接受治疗的III/IV期EOC女性患者的回顾性队列数据。采用逻辑回归分析法对临床和病理特征进行分析,以确定铂敏感性的独立预测因素。对无进展生存期(PFS)和总生存期(OS)的影响则通过卡普兰-梅耶(Kaplan-Meier)和考克斯回归分析来确定。结果 在 210 例患者中,139 例(66.19%)对铂敏感,71 例(33.81%)对铂耐药。在多变量分析中,铂耐药与新辅助化疗(OR 2.15;95% CI 1.10-4.21)、透明细胞/粘液组织学(OR 5.04;95% CI 2.20-11.54)和未达到最佳剥离状态(OR 3.37;95% CI 1.44-7.91)相关。接受新辅助化疗(分别为23个月对10个月和69个月对29个月)、透明细胞/黏液组织学(分别为15个月对3个月和63个月对11个月)和未达最佳剥除状态(分别为26个月对5个月和78个月对24个月)的患者的中位生存期和手术期也明显较短。队列中的提名图对铂敏感性具有良好的预测准确性,其一致性指数高达 0.745。结论 基于初始治疗类型、组织学和去势状态开发的新型预测提名图为预测晚期 EOC 女性患者的铂敏感性和生存结果提供了一种友好可靠的工具。它的应用可帮助临床医生做出个性化的治疗决定。
A nomogram to predict platinum-sensitivity and survival outcome in women with advanced epithelial ovarian cancer
Objective
This study presents the development and validation of a nomogram aimed at predicting platinum-sensitivity and survival outcomes in women with advanced epithelial ovarian cancer (EOC).
Materials and methods
Data from a retrospective cohort of women diagnosed with stage III/IV EOC between Jan 2011 and Dec 2021 treated at our institute were collected. Clinical and pathological characteristics were analyzed using logistic regression analysis to identify independent predictors of platinum-sensitivity. Impact on progression-free (PFS) and overall survival (OS) was determined by Kaplan–Meier and Cox regression analysis. A nomogram was constructed based on the significant predictors, and its performance was evaluated using calibration, discrimination, and validation analyses.
Results
Of the 210 patients, 139 (66.19%) had platinum-sensitive and 71 (33.81%) were platinum-resistant disease. On multivariate analysis, platinum-resistance correlated with neoadjuvant chemotherapy (OR 2.15; 95% CI 1.10–4.21), clear cell/mucinous histology (OR 5.04; 95% CI 2.20–11.54), and sub-optimal debulking status (OR 3.37; 95% CI 1.44–7.91). Median PFS and OS were also significantly shorter for patients with neoadjuvant chemotherapy (23 vs. 10 months and 69 vs. 29 months, respectively), clear cell/mucinous histology (15 vs. 3 months and 63 vs. 11 months, respectively), and suboptimal debulking (26 vs. 5 months and 78 vs. 24 months, respectively). The nomogram demonstrated good predictive accuracy for platinum-sensitivity in the cohort as indicated by high concordance index of 0.745. Calibration plots showed excellent agreement and internal validation further confirmed the reliability of the nomogram's performance.
Conclusion
A novel predictive nomogram based on type of initial treatment, histology, and debulking status was developed, which provides a friendly and reliable tool for predicting platinum-sensitivity and survival outcomes in women with advanced EOC. Its application may assist clinicians in individualizing treatment decisions.
期刊介绍:
Taiwanese Journal of Obstetrics and Gynecology is a peer-reviewed journal and open access publishing editorials, reviews, original articles, short communications, case reports, research letters, correspondence and letters to the editor in the field of obstetrics and gynecology.
The aims of the journal are to:
1.Publish cutting-edge, innovative and topical research that addresses screening, diagnosis, management and care in women''s health
2.Deliver evidence-based information
3.Promote the sharing of clinical experience
4.Address women-related health promotion
The journal provides comprehensive coverage of topics in obstetrics & gynecology and women''s health including maternal-fetal medicine, reproductive endocrinology/infertility, and gynecologic oncology. Taiwan Association of Obstetrics and Gynecology.