How low is low enough? Evaluation of various risk-assessment models for lymph node metastasis in endometrial cancer: a Korean multicenter study.
10.3802/jgo.2012.23.4.251
- Author:
Sokbom KANG
1
;
Jong Min LEE
;
Jae Kwan LEE
;
Jae Weon KIM
;
Chi Heum CHO
;
Seok Mo KIM
;
Sang Yoon PARK
;
Chan Yong PARK
;
Ki Tae KIM
Author Information
1. Center for Uterine Cancer, National Cancer Center, Goyang, Korea. sokbom@gmail.com
- Publication Type:Multicenter Study ; Original Article
- Keywords:
Endometrial cancer;
Low-risk group;
Lymph node dissection;
Lymphadenectomy;
Prediction;
Sensitivity and specificity
- MeSH:
Endometrial Neoplasms;
Female;
Humans;
Lymph Node Excision;
Lymph Nodes;
Medical Records;
Neoplasm Metastasis;
Prevalence;
Retrospective Studies;
Sensitivity and Specificity
- From:Journal of Gynecologic Oncology
2012;23(4):251-256
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The aim of this study was to identify a standard for the evaluation of future models for prediction of lymph node metastasis in endometrial cancer through estimation of performance of well-known surgicopathological models. METHODS: Using the medical records of 947 patients with endometrial cancer who underwent surgical management with lymphadenectomy, we retrospectively assessed the predictive performances of nodal metastasis of currently available models. RESULTS: We evaluated three models included: 1) a model modified from the Gynecologic Oncology Group (GOG) pilot study; 2) one from the GOG-33 data; and 3) one from Mayo Clinic data. The three models showed similar negative predictive values ranging from 97.1% to 97.4%. Using Bayes' theorem, this can be translated into 2% of negative post-test probability when 10% of prevalence of lymph node metastasis was assumed. In addition, although the negative predictive value was similar among these models, the proportion that was classified as low-risk was significantly different between the studies (56.4%, 44.8%, and 30.5%, respectively; p<0.001). CONCLUSION: The current study suggests that a false negativity of 2% or less should be a goal for determining clinical usefulness of preoperative or intraoperative prediction models for low-risk of nodal metastasis.
