A prognostic nomogram to predict overall survival in patients with platinum-sensitive recurrent ovarian cancer

C. K. Lee, R. J. Simes, C. Brown, V. Gebski, J. Pfisterer, A. M. Swart, D. Berton-Rigaud, M. Plante, T. Skeie-Jensen, I. Vergote, C. Schauer, C. Pisano, G. Parma, K. Baumann, J. A. Ledermann, E. Pujade-Lauraine, J. Bentley, G. Kristensen, A. Belau, M. Nankivell & 4 others U. Canzler, S. J. Lord, C. Kurzeder, M. Friedlander

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Patients with platinum-sensitive recurrent ovarian cancer have variable prognosis and survival. We extend previous work on prediction of progression-free survival by developing a nomogram to predict overall survival (OS) in these patients treated with platinum-based chemotherapy. Patients and methods: The nomogram was developed using data from the CAELYX in Platinum-Sensitive Ovarian Patients (CALYPSO) trial. Multivariate proportional hazards models were generated based on pre-treatment characteristics to develop a nomogram that classifies patient prognosis based on OS outcome. We also developed two simpler models with fewer variables and conducted model validations in independent datasets from AGO-OVAR Study 2.5 and ICON 4. We compare the performance of the nomogram with the simpler models by examining the differences in the C-statistics and net reclassification index (NRI). Results: The nomogram included six significant predictors: interval from last platinum chemotherapy, performance status, size of the largest tumour, CA-125, haemoglobin and the number of organ sites of metastasis (C-statistic 0.67; 95% confidence interval 0.65-0.69). Among the CALPYSO patients, the median OS for good, intermediate and poor prognosis groups was 56.2, 31.0 and 20.8 months, respectively. When CA-125 was not included in the model, the Cstatistics were 0.65 (CALYPSO) and 0.64 (AGO-OVAR 2.5). A simpler model (interval from last platinum chemotherapy, performance status and CA-125) produced a significant decrease of the C-statistic (0.63) and NRI (26.4%, P <0.0001). Conclusions: This nomogram with six pre-treatment characteristics improves OS prediction in patients with platinumsensitive ovarian cancer and is superior to models with fewer prognostic factors or platinum chemotherapy free interval alone. With independent validation, this nomogram could potentially be useful for improved stratification of patients in clinical trials and also for counselling patients.

Original languageEnglish
Article numbermds538
Pages (from-to)937-943
Number of pages7
JournalAnnals of Oncology
Volume24
Issue number4
DOIs
Publication statusPublished - Apr 2013

Fingerprint

Nomograms
Platinum
Ovarian Neoplasms
Survival
Drug Therapy
Proportional Hazards Models
Disease-Free Survival
Counseling
Hemoglobins
Clinical Trials
Confidence Intervals
Neoplasm Metastasis

Keywords

  • Nomogram
  • Overall survival
  • Platinum sensitivity
  • Prognosis
  • Recurrent ovarian cancer

ASJC Scopus subject areas

  • Oncology
  • Hematology

Cite this

Lee, C. K., Simes, R. J., Brown, C., Gebski, V., Pfisterer, J., Swart, A. M., ... Friedlander, M. (2013). A prognostic nomogram to predict overall survival in patients with platinum-sensitive recurrent ovarian cancer. Annals of Oncology, 24(4), 937-943. [mds538]. https://doi.org/10.1093/annonc/mds538

A prognostic nomogram to predict overall survival in patients with platinum-sensitive recurrent ovarian cancer. / Lee, C. K.; Simes, R. J.; Brown, C.; Gebski, V.; Pfisterer, J.; Swart, A. M.; Berton-Rigaud, D.; Plante, M.; Skeie-Jensen, T.; Vergote, I.; Schauer, C.; Pisano, C.; Parma, G.; Baumann, K.; Ledermann, J. A.; Pujade-Lauraine, E.; Bentley, J.; Kristensen, G.; Belau, A.; Nankivell, M.; Canzler, U.; Lord, S. J.; Kurzeder, C.; Friedlander, M.

In: Annals of Oncology, Vol. 24, No. 4, mds538, 04.2013, p. 937-943.

Research output: Contribution to journalArticle

Lee, CK, Simes, RJ, Brown, C, Gebski, V, Pfisterer, J, Swart, AM, Berton-Rigaud, D, Plante, M, Skeie-Jensen, T, Vergote, I, Schauer, C, Pisano, C, Parma, G, Baumann, K, Ledermann, JA, Pujade-Lauraine, E, Bentley, J, Kristensen, G, Belau, A, Nankivell, M, Canzler, U, Lord, SJ, Kurzeder, C & Friedlander, M 2013, 'A prognostic nomogram to predict overall survival in patients with platinum-sensitive recurrent ovarian cancer', Annals of Oncology, vol. 24, no. 4, mds538, pp. 937-943. https://doi.org/10.1093/annonc/mds538
Lee, C. K. ; Simes, R. J. ; Brown, C. ; Gebski, V. ; Pfisterer, J. ; Swart, A. M. ; Berton-Rigaud, D. ; Plante, M. ; Skeie-Jensen, T. ; Vergote, I. ; Schauer, C. ; Pisano, C. ; Parma, G. ; Baumann, K. ; Ledermann, J. A. ; Pujade-Lauraine, E. ; Bentley, J. ; Kristensen, G. ; Belau, A. ; Nankivell, M. ; Canzler, U. ; Lord, S. J. ; Kurzeder, C. ; Friedlander, M. / A prognostic nomogram to predict overall survival in patients with platinum-sensitive recurrent ovarian cancer. In: Annals of Oncology. 2013 ; Vol. 24, No. 4. pp. 937-943.
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abstract = "Background: Patients with platinum-sensitive recurrent ovarian cancer have variable prognosis and survival. We extend previous work on prediction of progression-free survival by developing a nomogram to predict overall survival (OS) in these patients treated with platinum-based chemotherapy. Patients and methods: The nomogram was developed using data from the CAELYX in Platinum-Sensitive Ovarian Patients (CALYPSO) trial. Multivariate proportional hazards models were generated based on pre-treatment characteristics to develop a nomogram that classifies patient prognosis based on OS outcome. We also developed two simpler models with fewer variables and conducted model validations in independent datasets from AGO-OVAR Study 2.5 and ICON 4. We compare the performance of the nomogram with the simpler models by examining the differences in the C-statistics and net reclassification index (NRI). Results: The nomogram included six significant predictors: interval from last platinum chemotherapy, performance status, size of the largest tumour, CA-125, haemoglobin and the number of organ sites of metastasis (C-statistic 0.67; 95{\%} confidence interval 0.65-0.69). Among the CALPYSO patients, the median OS for good, intermediate and poor prognosis groups was 56.2, 31.0 and 20.8 months, respectively. When CA-125 was not included in the model, the Cstatistics were 0.65 (CALYPSO) and 0.64 (AGO-OVAR 2.5). A simpler model (interval from last platinum chemotherapy, performance status and CA-125) produced a significant decrease of the C-statistic (0.63) and NRI (26.4{\%}, P <0.0001). Conclusions: This nomogram with six pre-treatment characteristics improves OS prediction in patients with platinumsensitive ovarian cancer and is superior to models with fewer prognostic factors or platinum chemotherapy free interval alone. With independent validation, this nomogram could potentially be useful for improved stratification of patients in clinical trials and also for counselling patients.",
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T1 - A prognostic nomogram to predict overall survival in patients with platinum-sensitive recurrent ovarian cancer

AU - Lee, C. K.

AU - Simes, R. J.

AU - Brown, C.

AU - Gebski, V.

AU - Pfisterer, J.

AU - Swart, A. M.

AU - Berton-Rigaud, D.

AU - Plante, M.

AU - Skeie-Jensen, T.

AU - Vergote, I.

AU - Schauer, C.

AU - Pisano, C.

AU - Parma, G.

AU - Baumann, K.

AU - Ledermann, J. A.

AU - Pujade-Lauraine, E.

AU - Bentley, J.

AU - Kristensen, G.

AU - Belau, A.

AU - Nankivell, M.

AU - Canzler, U.

AU - Lord, S. J.

AU - Kurzeder, C.

AU - Friedlander, M.

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N2 - Background: Patients with platinum-sensitive recurrent ovarian cancer have variable prognosis and survival. We extend previous work on prediction of progression-free survival by developing a nomogram to predict overall survival (OS) in these patients treated with platinum-based chemotherapy. Patients and methods: The nomogram was developed using data from the CAELYX in Platinum-Sensitive Ovarian Patients (CALYPSO) trial. Multivariate proportional hazards models were generated based on pre-treatment characteristics to develop a nomogram that classifies patient prognosis based on OS outcome. We also developed two simpler models with fewer variables and conducted model validations in independent datasets from AGO-OVAR Study 2.5 and ICON 4. We compare the performance of the nomogram with the simpler models by examining the differences in the C-statistics and net reclassification index (NRI). Results: The nomogram included six significant predictors: interval from last platinum chemotherapy, performance status, size of the largest tumour, CA-125, haemoglobin and the number of organ sites of metastasis (C-statistic 0.67; 95% confidence interval 0.65-0.69). Among the CALPYSO patients, the median OS for good, intermediate and poor prognosis groups was 56.2, 31.0 and 20.8 months, respectively. When CA-125 was not included in the model, the Cstatistics were 0.65 (CALYPSO) and 0.64 (AGO-OVAR 2.5). A simpler model (interval from last platinum chemotherapy, performance status and CA-125) produced a significant decrease of the C-statistic (0.63) and NRI (26.4%, P <0.0001). Conclusions: This nomogram with six pre-treatment characteristics improves OS prediction in patients with platinumsensitive ovarian cancer and is superior to models with fewer prognostic factors or platinum chemotherapy free interval alone. With independent validation, this nomogram could potentially be useful for improved stratification of patients in clinical trials and also for counselling patients.

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