Open AccessUsing a new diagnostic tool to predict lymph node metastasis in advanced epithelial ovarian cancer leads to simple lymphadenectomy decision rules: A multicentre study from the FRANCOGYN group
Author(s) -
Camille Mimoun,
Xavier Paolettí,
Thomas Gaillard,
Adrien Crestani,
J.-L. Bénifla,
M. Mezzadri,
Sofiane Bendifallah,
Chantal Touboul,
Alexandre Bricou,
Yohann Dabi,
Geoffroy Canlorbe,
Yohan Kerbage,
Vincent Lavoué,
Lobna Ouldamer,
Lise Lecointre,
Charles Coutant,
Arnaud Fauconnier,
Roman Rouzier,
Cyrille Huchon
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0258783
Subject(s) - medicine , lymphadenectomy , logistic regression , ovarian cancer , oncology , lymph node , retrospective cohort study , multivariate analysis , cancer
Objective The aim of this study was to develop a new diagnostic tool to predict lymph node metastasis (LNM) in patients with advanced epithelial ovarian cancer undergoing primary cytoreductive surgery. Materials and method The FRANCOGYN group’s multicenter retrospective ovarian cancer cohort furnished the patient population on which we developed a logistic regression model. The prediction model equation enabled us to create LNM risk groups with simple lymphadenectomy decision rules associated with a user-friendly free interactive web application called shinyLNM. Results 277 patients from the FRANCOGYN cohort were included; 115 with no LNM and 162 with LNM. Three variables were independently and significantly (p<0.05) associated with LNM in multivariate analysis: pelvic and/or para-aortic LNM on CT and/or PET/CT (p<0.00), initial PCI ≥ 10 and/or diaphragmatic carcinosis (p = 0.02), and initial CA125 ≥ 500 (p = 0.02). The ROC-AUC of this prediction model after leave-one-out cross-validation was 0.72. There was no difference between the predicted and the observed probabilities of LNM (p = 0.09). Specificity for the group at high risk of LNM was 83.5%, the LR+ was 2.73, and the observed probability of LNM was 79.3%; sensitivity for the group at low-risk of LNM was 92.0%, the LR- was 0.24, and the observed probability of LNM was 25.0%. Conclusion This new tool may prove useful for improving surgical planning and provide useful information for patients.