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Abstract
Background:
For
various malignancies, prognostic models have shown to be superior to
traditional staging systems in predicting overall survival. The purpose
of this study was to validate and compare the performance of three
prognostic models for overall survival in patients with advanced-stage
epithelial ovarian cancer.
Methods:
A
multi-institutional epithelial ovarian cancer database was used to
identify patients and to evaluate the predictive performance of two
nomograms, a prognostic index and FIGO (International Federation of
Obstetrics and Gynecology) stage. All patients were treated for
advanced-stage epithelial ovarian cancer between January 1996 and
January 2009 in 11 hospitals in the eastern part of The Netherlands.
Results:
In
total, 542 patients were found to be eligible. Overall performance did
not differ between the three prognostic models and FIGO stage. The
discriminative performance for Chi’s model was moderately good (c
indices 0.65 and 0.68) and for the models of Gerestein and Teramukai
reasonable (c indices between 0.60 and 0.62). The c indices of FIGO
stage ranged between 0.54 and 0.62. After recalibration, the three
models showed almost perfect calibration, whereas calibration of FIGO
stage was reasonable.
Conclusion:
The
three prediction models showed general applicability and a reasonably
well-predictive performance, especially in comparison to FIGO stage. To
date, there are no studies available that analyse the impact of these
prognostic models on decision-making and patient outcome. Therefore, the
usefulness of these models in daily clinical practice remains to be
investigated.
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