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. 2021 Jun 29;21(1):748.
doi: 10.1186/s12885-021-08466-4.

A nomogram prediction model for lymph node metastasis in endometrial cancer patients

Zhiling Wang  1 , Shuo Zhang  1 , Yifei Ma  2 , Wenhui Li  1 , Jiguang Tian  3 , Ting Liu  4
Affiliations

A nomogram prediction model for lymph node metastasis in endometrial cancer patients

Zhiling Wang et al. BMC Cancer. .

Abstract

Background: This study aimed to explore the risk factors for lymph node metastasis (LNM) in patients with endometrial cancer (EC) and develop a clinically useful nomogram based on clinicopathological parameters to predict it.

Methods: Clinical information of patients who underwent staging surgery for EC was abstracted from Qilu Hospital of Shandong University from January 1st, 2005 to June 31st, 2019. Parameters including patient-related, tumor-related, and preoperative hematologic examination-related were analyzed by univariate and multivariate logistic regression to determine the correlation with LNM. A nomogram based on the multivariate results was constructed and underwent internal and external validation to predict the probability of LNM.

Results: The overall data from the 1517 patients who met the inclusion criteria were analyzed. 105(6.29%) patients had LNM. According the univariate analysis and multivariate logistic regression analysis, LVSI is the most predictive factor for LNM, patients with positive LVSI had 13.156-fold increased risk for LNM (95%CI:6.834-25.324; P < 0.001). The nomogram was constructed and incorporated valuable parameters including histological type, histological grade, depth of myometrial invasion, LVSI, cervical involvement, parametrial involvement, and HGB levels from training set. The nomogram was cross-validated internally by the 1000 bootstrap sample and showed good discrimination accuracy. The c-index for internal and external validation of the nomogram are 0.916(95%CI:0.849-0.982) and 0.873(95%CI:0.776-0.970), respectively.

Conclusions: We developed and validated a 7-variable nomogram with a high concordance probability to predict the risk of LNM in patients with EC.

Keywords: Endometrial cancer; Lymph node metastasis; Lymphadenectomy; Nomogram.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Nomogram predicting the probability of LNM for women with EC
Fig. 2
Fig. 2
Internal calibration of the nomogram to predict LNM
Fig. 3
Fig. 3
Receiver operating characteristic curves of internal verification corresponding nomogram to predict LNM
Fig. 4
Fig. 4
Receiver operating characteristic curves of external verification corresponding nomogram to predict LNM
See this image and copyright information in PMC

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