A Preoperative Nomogram for Predicting Chemoresistance to Neoadjuvant Chemotherapy in Patients with Locally Advanced Cervical Squamous Carcinoma Treated with Radical Hysterectomy

Zhengjie Ou; Dan Zhao; Bin Li; Yating Wang; Shuanghuan Liu; Yanan Zhang

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자료유형: 학술저널

저자정보: Zhengjie Ou (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Dan Zhao (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Bin Li (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Yating Wang (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Shuanghuan Liu (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Yanan Zhang (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China)

저널정보: 대한암학회 Cancer Research and Treatment Cancer Research and Treatment 제53권 제1호

발행연도: 2021.1

수록면: 233 - 242 (10page)

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Purpose This study aimed to investigate the factors associated with chemoresistance to neoadjuvant chemotherapy (NACT) followed by radical hysterectomy (RH) and construct a nomogram to predict the chemoresistance in patients with locally advanced cervical squamous carcinoma (LACSC). Materials and Methods This retrospective study included 516 patients with International Federation of Gynecology and Obstetrics (2003) stage IB2 and IIA2 cervical cancer treated with NACT and RH between 2007 and 2017. Clinicopathologic data were collected, and patients were assigned to training (n=381) and validation (n=135) sets. Univariate and multivariate analyses were performed to analyze factors associated with chemoresistance to NACT. A nomogram was built using the multivariate logistic regression analysis results. We evaluated the discriminative ability and accuracy of the model using a concordance index and a calibration curve. The predictive probability of chemoresistance to NACT was defined as > 34%. Results Multivariate analysis confirmed menopausal status, clinical tumor diameter, serum squamous cell carcinoma antigen level, and parametrial invasion on magnetic resonance imaging before treatment as independent prognostic factors associated with chemoresistance to NACT. The concordance indices of the nomogram for training and validation sets were 0.861 (95% confidence interval [CI], 0.822 to 0.900) and 0.807 (95% CI, 0.807 to 0.888), respectively. Calibration plots revealed a good fit between the model-predicted probabilities and actual probabilities (Hosmer-Lemeshow test, p=0.597). Furthermore, grouping based on the nomogram was associated with progression-free survival. Conclusion We developed a nomogram for predicting chemoresistance in LACSC patients treated with RH. This nomogram can help physicians make clinical decisions regarding primary management and postoperative follow-up of the patients.

#Uterine cervical neoplasms #Neoadjuvant chemotherapy #Chemoresistance #Nomograms

참고문헌 (29)

참고문헌 신청

Bhatla N / 2018 / Cancer of the cervix uteri / Int J Gynaecol Obstet 143(Suppl 2):22~36

He D / 2015 / The safety and efficacy of the preoperative neoadjuvant chemotherapy for patients with cervical cancer : a systematic review and meta analysis / Int J Clin Exp Med 8:14693~14700

Neoadjuvant Chemotherapy for Locally Advanced Cervical Cancer Meta-analysis Collaboration / 2003 / Neoadjuvant chemotherapy for locally advanced cervical cancer : a systematic review and meta-analysis of individual patient data from 21randomised trials / Eur J Cancer 39:2470~2486

Hsieh HY / 2019 / Definite chemoradiotherapy is a competent treatment option in FIGO stage IB2 cervical cancer compared with radical surgery +/– neoadjuvant chemotherapy / J Formos Med Assoc 118:99~108

Katsumata N / 2013 / Phase III randomised controlled trial of neoadjuvant chemotherapy plus radical surgery vs radical surgery alone for stages IB2, IIA2, and IIB cervical cancer : a Japan Clinical Oncology Group trial(JCOG 0102) / Br J Cancer 108:1957~1963

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