J 2022

External validation study of endometrial cancer preoperative risk stratification model (ENDORISK)

VINKLEROVÁ, Petra, Petra OVESNÁ, Jitka HAUSNEROVÁ, Johanna M. A. PIJNENBORG, Peter J. F. LUCAS et. al.

Basic information

Original name

External validation study of endometrial cancer preoperative risk stratification model (ENDORISK)

Authors

VINKLEROVÁ, Petra (203 Czech Republic, belonging to the institution), Petra OVESNÁ (203 Czech Republic, belonging to the institution), Jitka HAUSNEROVÁ (203 Czech Republic, belonging to the institution), Johanna M. A. PIJNENBORG, Peter J. F. LUCAS, Reijnen CASPER, Vrede STEPHANIE and Vít WEINBERGER (203 Czech Republic, guarantor, belonging to the institution)

Edition

Frontiers in Oncology, Lausanne, Frontiers, 2022, 2234-943X

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30204 Oncology

Country of publisher

Switzerland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 4.700

RIV identification code

RIV/00216224:14110/22:00126395

Organization unit

Faculty of Medicine

UT WoS

000841408200001

Keywords in English

Bayesian networks model; disease-specific survival; endometrial cancer; prognosis; risk stratification; sentinel node biopsy; lymph node metastasis

Tags

International impact, Reviewed
Změněno: 16/1/2023 12:29, Mgr. Tereza Miškechová

Abstract

V originále

Introduction: Among industrialized countries, endometrial cancer is a common malignancy with generally an excellent outcome. To personalize medicine, we ideally compile as much information as possible concerning patient prognosis prior to effecting an appropriate treatment decision. Endometrial cancer preoperative risk stratification (ENDORISK) is a machine learning–based computational Bayesian networks model that predicts lymph node metastasis and 5-year disease-specific survival potential with percentual probability. Our objective included validating ENDORISK effectiveness in our patient cohort, assessing its application in the current use of sentinel node biopsy, and verifying its accuracy in advanced stages. Methods: The ENDORISK model was evaluated with a retrospective cohort of 425 patients from the University Hospital Brno, Czech Republic. Two hundred ninety-nine patients were involved in our disease-specific survival analysis; 226 cases with known lymph node status were available for lymph node metastasis analysis. Patients were included undergoing either pelvic lymph node dissection (N = 84) or sentinel node biopsy (N =70) to explore the accuracy of both staging procedures. Results: The area under the curve was 0.84 (95% confidence interval [CI], 0.77–0.9) for lymph node metastasis analysis and 0.86 (95% CI, 0.79–0.93) for 5-year disease-specific survival evaluation, indicating quite positive concordance between prediction and reality. Calibration plots to visualize results demonstrated an outstanding predictive value for low-risk cancers (grades 1–2), whereas outcomes were underestimated among high-risk patients (grade 3), especially in disease-specific survival. This phenomenon was even more obvious when patients were subclassified according to FIGO clinical stages. Conclusions: Our data confirmed ENDORISK model’s laudable predictive ability, particularly among patients with a low risk of lymph node metastasis and expected favorable survival. For high-risk and/or advanced stages, the ENDORISK network needs to be additionally trained/improved.