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        Prognostic models for locally advanced cervical cancer: external validation of the published models

        David Lora,Agustín Gómez de la Cámara,Sara Pedraza Fernández,Rafael Enríquez de Salamanca,José Fermín Pérez-Regadera Gómez 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.5

        Objective: To externally validate the prognostic models for predicting the time-dependentoutcome in patients with locally advanced cervical cancer (LACC) who were treated withconcurrent chemoradiotherapy in an independient cohort. Methods: A historical cohort of 297 women with LACC who were treated with radicalconcurrent chemoradiotherapy from 1999 to 2014 at the 12 de Octubre University Hospital(H12O), Madrid, Spain. The external validity of prognostic models was quantified regardingdiscrimination, calibration, measures of overall performance, and decision curve analyses. Results: The review identified 8 studies containing 13 prognostic models. Different(International Federation of Gynecology and Obstetrics [FIGO] stages, parametriuminvolvement, hydronephrosis, location of positive nodes, and race) but related cohorts withvalidation cohort (5-year overall survival [OS]=70%; 5-year disease-free survival [DFS]=64%;average age of 50; and over 79% squamous cell) were evaluated. The following models exhibitedgood external validity in terms of discrimination and calibration but limited clinical utility: theOS model at 3 year from Kidd et al.'s study (area under the receiver operating characteristiccurve [AUROC]=0.69; threshold of clinical utility [TCU] between 36% and 50%), the models ofDFS at 1 year from Kidd et al.'s study (AUROC=0.64; TCU between 24% and 32%) and 2 yearsfrom Rose et al.'s study (AUROC=0.70; TCU between 19% and 58%) and the distant recurrencemodel at 5 years from Kang et al.'s study (AUROC=0.67; TCU between 12% and 36%). Conclusion: The external validation revealed the statistical and clinical usefulness of 4prognostic models published in the literature.

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