Comparing survival outcomes between surgical and non-surgical treatments in patients with early-onset endometrial cancer and developing a nomogram to predict survival: a study based on Eastern and Western data sets
Abstract Background Surgery is the preferred approach for treating endometrial cancer (EC). However, the prognosis of young women undergoing surgery has not been thoroughly evaluated. This study aims to establish a prognostic nomogram for predicting overall survival (OS) in postoperative patients wi...
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BMC
2025-05-01
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| Series: | World Journal of Surgical Oncology |
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| Online Access: | https://doi.org/10.1186/s12957-025-03825-y |
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| author | Yunfeng Zheng Ran Hu Fan Yang Gaohua Liu Tianyu Peng Langting Xie Jie Wu Lamei Hou Rui Yuan |
| author_facet | Yunfeng Zheng Ran Hu Fan Yang Gaohua Liu Tianyu Peng Langting Xie Jie Wu Lamei Hou Rui Yuan |
| author_sort | Yunfeng Zheng |
| collection | DOAJ |
| description | Abstract Background Surgery is the preferred approach for treating endometrial cancer (EC). However, the prognosis of young women undergoing surgery has not been thoroughly evaluated. This study aims to establish a prognostic nomogram for predicting overall survival (OS) in postoperative patients with early-onset endometrial cancer (EOEC), facilitating risk stratification for high-risk patients. Methods Patients diagnosed with EOEC during 2004–2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The nomogram of OS was established according to the multivariate Cox regression analyses. The prediction accuracy and clinical net benefit of the model were assessed by the concordance index (C-index), receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA). Additionally, external validation was performed with 230 EOEC patients who underwent primary surgical treatment at the First Affiliated Hospital of Chongqing Medical University from 2013 to 2018. Results The mean survival period in the surgical group of EOEC was 87.62 months (range: 86.92–88.32), compared to 64.00 months (range: 55.05–72.96) in the non-surgical group. Compared with the non-surgical group, patients who underwent surgery had better outcomes. A total of 4345 eligible postoperative patients with EOEC were identified and enrolled in this study. Multivariate Cox analysis showed that age, race, grade, T stage, tumor size, and lymphadenectomy were significantly associated with the prognosis of EOEC, which were further incorporated to construct a nomogram. C-index and DCA showed the predictive capability and the clinical applicability of the nomogram was superior over the TNM stage and SEER stage. Furthermore, the external validation using the FAHCQMU cohort consistently demonstrated good predictive accuracy. Conclusions Generally, we developed a novel nomogram model by comprehensively integrating multiple risk factors, which accurately predicts the clinical prognosis of EOEC patients after surgery. |
| format | Article |
| id | doaj-art-509fbb022531422ba2d3d38cf2cef022 |
| institution | Kabale University |
| issn | 1477-7819 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj-art-509fbb022531422ba2d3d38cf2cef0222025-08-20T03:53:58ZengBMCWorld Journal of Surgical Oncology1477-78192025-05-0123111510.1186/s12957-025-03825-yComparing survival outcomes between surgical and non-surgical treatments in patients with early-onset endometrial cancer and developing a nomogram to predict survival: a study based on Eastern and Western data setsYunfeng Zheng0Ran Hu1Fan Yang2Gaohua Liu3Tianyu Peng4Langting Xie5Jie Wu6Lamei Hou7Rui Yuan8Department of Gynecology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Gynecology, The First Affiliated Hospital of Chongqing Medical UniversityCentre for Lipid Research & Chongqing Key Laboratory of Metabolism On Lipid and Glucose, Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Department of Infectious Diseases, the Second Affiliated Hospital, Chongqing Medical UniversityInstitute of Clinical Medicine, Hengyang Medical School, The First Affiliated Hospital, University of South ChinaDepartment of Gynecology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Gynecology and Obstetrics, Fujian Medical University Union HospitalDepartment of Gynecology, People’s Hospital of FengjieDepartment of Gynecology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Gynecology, The First Affiliated Hospital of Chongqing Medical UniversityAbstract Background Surgery is the preferred approach for treating endometrial cancer (EC). However, the prognosis of young women undergoing surgery has not been thoroughly evaluated. This study aims to establish a prognostic nomogram for predicting overall survival (OS) in postoperative patients with early-onset endometrial cancer (EOEC), facilitating risk stratification for high-risk patients. Methods Patients diagnosed with EOEC during 2004–2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The nomogram of OS was established according to the multivariate Cox regression analyses. The prediction accuracy and clinical net benefit of the model were assessed by the concordance index (C-index), receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA). Additionally, external validation was performed with 230 EOEC patients who underwent primary surgical treatment at the First Affiliated Hospital of Chongqing Medical University from 2013 to 2018. Results The mean survival period in the surgical group of EOEC was 87.62 months (range: 86.92–88.32), compared to 64.00 months (range: 55.05–72.96) in the non-surgical group. Compared with the non-surgical group, patients who underwent surgery had better outcomes. A total of 4345 eligible postoperative patients with EOEC were identified and enrolled in this study. Multivariate Cox analysis showed that age, race, grade, T stage, tumor size, and lymphadenectomy were significantly associated with the prognosis of EOEC, which were further incorporated to construct a nomogram. C-index and DCA showed the predictive capability and the clinical applicability of the nomogram was superior over the TNM stage and SEER stage. Furthermore, the external validation using the FAHCQMU cohort consistently demonstrated good predictive accuracy. Conclusions Generally, we developed a novel nomogram model by comprehensively integrating multiple risk factors, which accurately predicts the clinical prognosis of EOEC patients after surgery.https://doi.org/10.1186/s12957-025-03825-yEndometrial cancerearly-onsetNomogramOverall survivalRisk stratificationSEER |
| spellingShingle | Yunfeng Zheng Ran Hu Fan Yang Gaohua Liu Tianyu Peng Langting Xie Jie Wu Lamei Hou Rui Yuan Comparing survival outcomes between surgical and non-surgical treatments in patients with early-onset endometrial cancer and developing a nomogram to predict survival: a study based on Eastern and Western data sets World Journal of Surgical Oncology Endometrial cancer early-onset Nomogram Overall survival Risk stratification SEER |
| title | Comparing survival outcomes between surgical and non-surgical treatments in patients with early-onset endometrial cancer and developing a nomogram to predict survival: a study based on Eastern and Western data sets |
| title_full | Comparing survival outcomes between surgical and non-surgical treatments in patients with early-onset endometrial cancer and developing a nomogram to predict survival: a study based on Eastern and Western data sets |
| title_fullStr | Comparing survival outcomes between surgical and non-surgical treatments in patients with early-onset endometrial cancer and developing a nomogram to predict survival: a study based on Eastern and Western data sets |
| title_full_unstemmed | Comparing survival outcomes between surgical and non-surgical treatments in patients with early-onset endometrial cancer and developing a nomogram to predict survival: a study based on Eastern and Western data sets |
| title_short | Comparing survival outcomes between surgical and non-surgical treatments in patients with early-onset endometrial cancer and developing a nomogram to predict survival: a study based on Eastern and Western data sets |
| title_sort | comparing survival outcomes between surgical and non surgical treatments in patients with early onset endometrial cancer and developing a nomogram to predict survival a study based on eastern and western data sets |
| topic | Endometrial cancer early-onset Nomogram Overall survival Risk stratification SEER |
| url | https://doi.org/10.1186/s12957-025-03825-y |
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