Development and internal validation of a prognostic model for survival after debulking surgery for epithelial ovarian cancer

M. J. Rutten, J. H.L. Boldingh, E. Schuit, H. Trum, W. Van Driel, B. W.J. Mol, G. G. Kenter, M. R. Buist

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20 Citations (Scopus)


Objective. Predicting survival of patients with epithelial ovarian cancer (EOC) is based on prognosis of the population. Combining prognostic factors could facilitate survival prediction on the level of the individual patient. The aim of this study was to develop a prognostic model to predict five-year disease specific survival in patients with EOC, and to evaluate whether this would add to prediction based on prognosis of the population.

Patients and methods. A retrospective cohort study was performed of all EOC patients treated with primary debulking and adjuvant chemotherapy or neo-adjuvant chemotherapy and interval debulking surgery in three gynaecological-oncologic centres between 1998 and 2010. Primary outcomewas 5-year disease-specific survival. We developed a Cox proportional hazardmodel using the LASSO-method to select the best combination of characteristics from12 potential predictors and to correct for overfitting. Performance of themodelwas expressed as calibration and discrimination (c-statistic). A nomogram was developed to increase the clinical applicability of the model.

Results. Of 840 patients with EOC 462 (55%) died within 5 years due to the disease. A combination of FIGO stage, residual tumour after surgery, primary or interval surgery, histology, performance status, age, amount of ascites and a family history suggestive of breast/ovarian cancer best predicted 5-year survival. The final model showed accurate calibration and the c-statistic was 0.71 (95% CI 0.69-0.74).

Conclusions. Five-year survival in all stage EOC patients can be predicted accurately using available characteristics. After external validation the model can be used for counselling of patients.

Original languageEnglish
Pages (from-to)13-18
Number of pages6
JournalGynecologic oncology
Issue number1
Publication statusPublished or Issued - 1 Oct 2014
Externally publishedYes


  • Debulking surgery
  • Nomogram
  • Ovarian cancer
  • Prediction
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology

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