A nomogram to predict platinum-sensitivity and survival outcome in women with advanced epithelial ovarian cancer

• Published in: Taiwanese journal of obstetrics & gynecology Vol. 63; no. 5; pp. 709 - 716
• Main Authors: Yeh, Tsung-Hsin, Wu, Chen-Hsuan, Ou, Yu-Che, Fu, Hung-Chun, Lin, Hao
• Format: Journal Article
• Language: English
• Published: China (Republic : 1949- ) Elsevier B.V 01.09.2024; Elsevier
• Subjects: Adult; Advanced ovarian cancer; Aged; Antineoplastic Agents - therapeutic use; Carcinoma, Ovarian Epithelial - drug therapy; Carcinoma, Ovarian Epithelial - mortality; Carcinoma, Ovarian Epithelial - pathology; Cytoreduction Surgical Procedures; Drug Resistance, Neoplasm; Female; Humans; Internal Medicine; Kaplan-Meier Estimate; Middle Aged; Neoadjuvant Therapy - methods; Neoplasm Staging; Nomograms; Obstetrics and Gynecology; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - mortality; Ovarian Neoplasms - pathology; Platinum - therapeutic use; Platinum-sensitivity; Prediction model; Progression-Free Survival; Retrospective Studies; Advanced ovarian cancer; Platinum-sensitivity; Prediction model
• ISSN: 1028-4559; 1875-6263
• DOI: 10.1016/j.tjog.2024.05.022

AbstractObjectiveThis 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 methodsData 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. ResultsOf 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. ConclusionA 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.