Skip Navigation LinksHome > March 2014 - Volume 24 - Issue 3 > A Web-Based Nomogram Predicting Para-aortic Nodal Metastasis...
International Journal of Gynecological Cancer:
doi: 10.1097/IGC.0000000000000090
Uterine Cancer

A Web-Based Nomogram Predicting Para-aortic Nodal Metastasis in Incompletely Staged Patients With Endometrial Cancer: A Korean Multicenter Study

Kang, Sokbom MD, PhD*; Lee, Jong-Min MD, PhD; Lee, Jae-Kwan MD, PhD; Kim, Jae-Weon MD, PhD§; Cho, Chi-Heum MD, PhD; Kim, Seok-Mo MD, PhD; Park, Sang-Yoon MD, PhD*; Park, Chan-Yong MD, PhD#; Kim, Ki-Tae MD, PhD**

Collapse Box


Objective: The purpose of this study is to develop a Web-based nomogram for predicting the individualized risk of para-aortic nodal metastasis in incompletely staged patients with endometrial cancer.

Methods: From 8 institutions, the medical records of 397 patients who underwent pelvic and para-aortic lymphadenectomy as a surgical staging procedure were retrospectively reviewed. A multivariate logistic regression model was created and internally validated by rigorous bootstrap resampling methods. Finally, the model was transformed into a user-friendly Web-based nomogram (http://

Results: The rate of para-aortic nodal metastasis was 14.4% (57/397 patients). Using a stepwise variable selection, 4 variables including deep myometrial invasion, non–endometrioid subtype, lymphovascular space invasion, and log-transformed CA-125 levels were finally adopted. After 1000 repetitions of bootstrapping, all of these 4 variables retained a significant association with para-aortic nodal metastasis in the multivariate analysis—deep myometrial invasion (P = 0.001), non–endometrioid histologic subtype (P = 0.034), lymphovascular space invasion (P = 0.003), and log-transformed serum CA-125 levels (P = 0.004). The model showed good discrimination (C statistics = 0.87; 95% confidence interval, 0.82–0.92) and accurate calibration (Hosmer-Lemeshow P = 0.74).

Conclusions: This nomogram showed good performance in predicting para-aortic metastasis in patients with endometrial cancer. The tool may be useful in determining the extent of lymphadenectomy after incomplete surgery.

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


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.

Connect With Us


For additional oncology content, visit LWW Oncology Journals on Facebook.