Prediction model of postoperative recurrence and metastasis in cervical cancer patients based on Cox regression combined risk score
Objective The risk factors affecting the progression of postoperative recurrence and metastasis of cervical cancer patients were analyzed and the prediction model was constructed based on Cox regression combined risk score.Methods A total of 152 patients with cervical cancer who received radical cervical cancer surgery in Jiangsu Cancer Hospital from June 1,2014 to December 31,2015 were retrospectively selected and divided into modeling group(n=102)and verification group(n=50)by random number table method in a 2:1 ratio.Multivariate Cox regression analysis was performed to an-alyze the risk factors of postoperative recurrence and metastasis in the modeling group.A risk score model was developed;Receiver operating characteristic curve(ROC)and calibration curve were used to evaluate the model internally and exter-nally.Results Diagnostic stage 4(HR=12.972,95％CI:3.621-46.472),poorly differentiated(HR=3.535,95％CI:1.258-4.012),adenocarcinoma(HR=2.366,95％CI:1.587-5.236),and lymph node metastasis(HR=5.851,95％CI:3.524-7.689)were independent risk factors for recurrence and metastasis 5 years after surgery in cervical cancer pa-tients(P＜0.05).The results of the risk score model showed that the low-risk group(45 cases)scored 0-5 points,the medium-risk group(36 cases)scored 6-10 points,and the high-risk group(21 cases)scored 11-14 points.The recur-rence and progression rates of the three groups were significantly different(x2=10.338,P=0.006).There was signifi-cant difference in the 5-year recurrence and metastasis progression rate among the 3 groups,x2=5.294,P=0.021.The ROC curve AUC values of the model group and the verification group were 0.886(95％CI:0.813-0.905)and 0.884(95％CI:0.811-0.901),respectively,indicating good accuracy and differentiation of the model.Conclusion Diagnostic stage 4,low differentiation,adenocarcinoma and lymph node metastasis are closely related to postoperative recurrence and metastasis of cervical cancer patients.Cox regression combined risk score model has a good effect on predicting postopera-tive recurrence and metastasis of patients.
uterine cervical carcinomarisk assessment modelprogression phaserecurrence and metastasiscox regression analysis
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