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External Validation of a Nomogram for Predicting Survival of Women With Uterine Cancer in a Cohort of African American Patients

Alagkiozidis, Ioannis MD*; Wilson, Kirstie MD*; Ruffner, Nicole MD*; Weedon, Jeremy PhD; Serur, Eli MD*; Economos, Katherine MD*; Abulafia, Ovadia MD*; Lee, Yi-Chun MD*; Salame, Ghadir MD*

International Journal of Gynecological Cancer: January 2014 - Volume 24 - Issue 1 - p 85–90
doi: 10.1097/IGC.0000000000000039
Uterine Cancer

Objective: This study aimed to externally validate a nomogram for predicting overall survival of women with uterine cancer in an African American population.

Methods: After the institutional review board approval, data from the uterine cancer database from 2 major teaching hospitals in Brooklyn, NY, were analyzed. The predicted survival for each patient was calculated with the use of the nonogram; the data were clustered in deciles and compared with the observed survival data.

Results: High incidence of aggressive histologic types (22% carcinosarcoma, 16% serous/clear cell), poorly differentiated (53% grade 3), and advanced stage (38% stage III or IV) tumors was found in our study population. The median follow-up for survivors was 52 months (range, 1–274 months). The observed and predicted 3-year overall survival probabilities were significantly different (62.5% vs 72.6%, P < 0.001). Similarly, the observed 5-year overall survival probability was significantly lower than the predicted by the nomogram (55.5% vs 63.4%, P < 0.001). The discrepancy between predicted and observed survival was more pronounced in the midrisk groups.

Conclusions: The nomogram is not an adequate tool to predict survival in the African American population with cancer of the uterine corpus. Race seems to be a significant, independent factor that affects survival and should be included in predictive models.

Departments of *Gynecologic Oncology, and †Statistics, SUNY Downstate Medical Center, Brooklyn, NY.

Address correspondence and reprint requests to Ioannis Alagkiozidis, MD, 450 Clarkson Ave, PO Box 25, Brooklyn, N Y 11203. E-mail:

The authors declare no conflicts of interest.

Received January 14, 2013

Accepted October 17, 2013

© 2014 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.