Article Text

Download PDFPDF
Nomogram to Predict the Probability of Relapse in Patients Diagnosed With Borderline Ovarian Tumors
  1. Andreas Obermair, MD, FRANZCOG, CGO*,,
  2. Amy Tang, MBBS, FRANZCOG, CGO*,
  3. Srinivas Kondalsamy–Chennakesavan, MBBS, MPH,
  4. Hextan Ngan, MD,
  5. Petra Zusterzeel, MD, PhD§,
  6. Michael Quinn, MBV ChB, MGO, MRCP (UK), FRANZCOG, FRCOG, CGO,
  7. Jonathan Carter, MBBS, FRACOG, CGO,
  8. Yee Leung, MBBS FRANZCOG CGO# and
  9. Monika Janda, PhD**
  1. *Queensland Centre for Gynaecological Cancer, Royal Brisbane& Women’s Hospital;
  2. University of Queensland, Brisbane, Australia;
  3. Queen Mary Hospital, Hong Kong;
  4. §Radboud University Medical Centre, Nijmegen, The Netherlands;
  5. Royal Women’s Hospital Melbourne;
  6. Royal Prince Alfred Hospital, Sydney;
  7. #School of Women’s and Infants’ Health, University of Western Australia, Perth; and
  8. **School of Public Health, Queensland University of Technology, Brisbane, Australia.
  1. Address correspondence and reprint requests to Andreas Obermair, MD, FRANZCOG, CGO, School of Medicine, The University of Queensland, Brisbane, Royal Brisbane and Women’s Hospital, 6th Floor, Ned Hanlon Bldg, Butterfield St, Herston, QLD 4029, Australia. E-mail:


Objective This study aimed to develop a nomogram predicting the probability of relapse in individual patients who have surgery for borderline ovarian tumors (BOTs).

Methods This retrospective study included 801 patients with BOT diagnosed between 1985 and 2008 at 6 gynecologic cancer centers. We analyzed covariates that were associated with the risk of developing a recurrence by multivariate logistic regression. We identified a parsimonious model by backward stepwise logistic regression. The 5 most significant or clinically important variables associated with an increased risk of recurrence were included in the nomogram. The nomogram was internally validated.

Results Fifty-one patients developed a recurrence after a median observation period of 57 months. Age at diagnosis, the International Federation of Gynecology and Obstetrics stage, cell type, preoperative serum CA125, and type of surgery (radical vs fertility-sparing) were associated with an increased risk of recurrence and were used in the nomogram. Bootstrap-corrected concordance index was 0.67 and showed good calibration.

Conclusions Five factors that are commonly available to clinicians treating patients with BOT were used in the development of a nomogram to predict the risk of recurrence. The nomogram will be useful to counsel patients about risk-reduction strategies to minimize the risk of recurrence or to inform patients about a very low risk of recurrence making intensive follow-up unwarranted.

  • Borderline ovarian tumors
  • CA125
  • Survival

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • This study was partly funded by the Royal Brisbane and Women’s Hospital Research Foundation, Brisbane, Australia.

  • The authors declare no conflicts of interest.

  • Article Category: Cancer therapy