RT Journal Article
SR Electronic
T1 EP1253 A novel model to predict cancer-specific survival in patients with early-stage uterine papillary serous carcinoma (UPSC)
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP A630
OP A630
DO 10.1136/ijgc-2019-ESGO.1259
VO 29
IS Suppl 4
A1 Lihua, C
A1 Xi, C
YR 2019
UL http://ijgc.bmj.com/content/29/Suppl_4/A630.1.abstract
AB Introduction/Background Uterine papillary serous carcinoma (UPSC) has aggressively biological behavior and leads to poor prognosis. However, clinicopathologic risk factors to predict cancer-specific survival of patients with stage I-II UPSC were still unclear. This study was undertaken to develop a prediction model of survival in patients with early-stage UPSC.Methodology Using SEER database, we identified 964 patients with FIGO stage I-II UPSC who underwent at least hysterectomy between 2004–2015. Using proportional subdistribution hazards regression to compare cancer-specific death (CSD) for all patients. Based on the results of univariate and multivariate analysis, the variables were selected to construct a predictive model; and the prediction results of the model were visualized by nomogram to predict the cancer-specific survival and the response to adjuvant therapy of stage I-II UPSC patients.Results The median age of the cohort is 67 years old. 17.1% (n=165) of the patients died of UPSC, while 8.6% of the patients died from other causes. On multivariate analysis, age (HR=1.45, P=0.021), tumor size (HR=1.81, P=0.014) and number of regional nodes removed (HR=0.52, P=0.003) were significantly associated with cumulative incidence of CSD. In the age≥67 years cohort, FIGO stage I-II was a risk factor for CSD (HR=1.83, P=0.036), and ≥ 10 lymph nodes removed was a protective factor (HR=0.50, P=0.01). Both combination of adjuvant chemotherapy and radiotherapy and adjuvant chemotherapy alone decreased the CSD of patients with stage I-II UPSC older than 67 years (HR=0.47, P=0.022; HR=0.52, P=0.024, respectively). The prediction model had great risk stratification ability as high-risk group had higher cumulative incidence of CSD than low-risk group (P<0.001). In the high-risk group, patients with adjuvant chemoradiotherapy had improved CSD compared with patients who did not receive any adjuvant therapy (P=0.037).Conclusion Our prediction model has a good performance in predicting cancer-specific survival of early-stage UPSC patients and contributes to guide clinical treatment decision.Disclosure Nothing to disclose