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. 2022 Jun 30:9:866283.
doi: 10.3389/fmed.2022.866283. eCollection 2022.

Nomogram Predicting Lymph Node Metastasis in the Early-Stage Cervical Cancer

Shimin Yang  1 , Chunli Liu  2 , Chunbo Li  1 , Keqin Hua  1
Affiliations

Nomogram Predicting Lymph Node Metastasis in the Early-Stage Cervical Cancer

Shimin Yang et al. Front Med (Lausanne). .

Abstract

Background: Accurately predicting the risk level of lymph node metastasis is essential for the treatment of patients with early cervical cancer. The purpose of this study is to construct a new nomogram based on 2-deoxy-2-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and clinical characteristics to assess early-stage cervical cancer patients' risk of lymph node metastasis.

Materials and methods: From January 2019 to November 2020, the records of 234 patients with stage IA-IIA [International Federation of Gynecology and Obstetrics (FIGO) 2018] cervical cancer who had undergone PET/CT examination within 30 days before surgery were retrospectively reviewed. A nomogram to predict the risk of lymph node metastasis was constructed based on it. The nomogram was developed and validated by internal and external validation. The validation cohorts included 191 cervical cancer patients from December 2020 to October 2021.

Results: Four factors [squamous cell carcinoma associated antigen (SCCA), maximum standardized uptake value of lymph node (nSUVmax), uterine corpus invasion in PET/CT and tumor size in PET/CT] were finally determined as the predictors of the nomogram. At the area under the receiver operating characteristic curve cohort was 0.926 in the primary and was 0.897 in the validation cohort. The calibration curve shows good agreement between the predicted probability and the actual probability. The decision curve analysis showed the clinical utility of the nomogram.

Conclusion: We had established and verified a simple and effective nomogram, which can be used to predict the lymph node metastasis of cervical cancer patients before surgery.

Keywords: PET/CT; cervical cancer; decision curve analysis; lymph node metastasis; nomogram.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
A nomogram predicting the risk of lymph node metastasis in early-stage cervical cancer patients. nSUVmax, maximum standardized uptake value of lymph node; SCCA, squamous cell carcinoma associated antigen; PET/CT, positron emission tomography/computed tomography; LN, lymph node.
FIGURE 2
FIGURE 2
The area under the receiver operating characteristics curve (AUC-ROC) of the model in the primary (A) and the validation cohort (B), respectively. Calibration curves of the nomogram for the primary (C) and validation cohort (D).
FIGURE 3
FIGURE 3
Decision curve analysis for the nomogram.
See this image and copyright information in PMC

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