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KMID : 1137020120230040251
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Journal of Gynecologic Oncology
2012 Volume.23 No. 4 p.251 ~ p.256
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How low is low enough? Evaluation of various risk-assessment models for lymph node metastasis in endometrial cancer: a Korean multicenter study
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Kang Sok-Bom
Lee Jong-Min
Lee Jae-Kwan
Kim Jae-Weon
Cho Chi-Heum
Kim Seok-Mo
Park Sang-Yoon
Park Chan-Yong
Kim Ki-Tae
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Abstract
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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.
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KEYWORD
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Endometrial cancer, Low-risk group, Lymph node dissection, Lymphadenectomy, Prediction, Sensitivity and specificity
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