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Use of complex surgical procedures, patterns of tumor spread, and CA-125 predicts a risk of incomplete cytoreduction: A Korean Gynecologic Oncology Group study (KGOG-3022)
DC Field | Value | Language |
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dc.contributor.author | 정대철 | - |
dc.date.accessioned | 2014-12-18T09:30:32Z | - |
dc.date.available | 2014-12-18T09:30:32Z | - |
dc.date.issued | 2013 | - |
dc.identifier.issn | 0090-8258 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/88300 | - |
dc.description.abstract | OBJECTIVES: We aimed to develop a risk model to predict a risk of suboptimal cytoreduction in primary surgery of ovarian cancer. METHODS: The clinical records and computed tomography (CT) data of 358 patients with stages II-IV epithelial ovarian cancer were reviewed. Tumor spread patterns identified by principal component analysis, CA-125, and a newly developed surgical skill index were integrated into a logistic model along with other variables. Internal validation was performed using bootstrapped re-sampling and calibration was assessed by goodness-of-fit test. RESULTS: Among the 358 patients, optimal cytoreduction, which was defined as no residual tumor, was achieved in 145 patients (40.5%). The surgical capacity of an individual institution was estimated by a surgical skill index, which was the frequency of complex surgeries in patients with advanced disease. In a multivariate model, two distinctive CT patterns of tumor spread (diffuse spread pattern and upper abdominal extension pattern), a surgical skill index, and serum CA-125 independently predicted a risk of suboptimal cytoreduction (P=0.006, P=0.013, P=0.031, and P=0.001, respectively). The model showed a C-statistic of .73 (95% confidence interval .67 to .79), which was significantly higher than tumor stage or ascites. Rigorous internal validation by bootstrapped re-sampling successfully confirmed the model. CONCLUSIONS: We identified two distinct tumor spread patterns of ovarian cancer, which can be integrated to improve a prediction model. Our model may be useful in patient referral or clinical trials for patient stratification. | - |
dc.description.statementOfResponsibility | open | - |
dc.relation.isPartOf | GYNECOLOGIC ONCOLOGY | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/2.0/kr/ | - |
dc.subject.MESH | Adult | - |
dc.subject.MESH | Aged | - |
dc.subject.MESH | CA-125 Antigen/blood | - |
dc.subject.MESH | Female | - |
dc.subject.MESH | Gynecologic Surgical Procedures/methods | - |
dc.subject.MESH | Gynecologic Surgical Procedures/standards | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Logistic Models | - |
dc.subject.MESH | Membrane Proteins/blood | - |
dc.subject.MESH | Middle Aged | - |
dc.subject.MESH | Models, Statistical* | - |
dc.subject.MESH | Neoplasm Staging | - |
dc.subject.MESH | Neoplasms, Glandular and Epithelial/blood | - |
dc.subject.MESH | Neoplasms, Glandular and Epithelial/pathology* | - |
dc.subject.MESH | Neoplasms, Glandular and Epithelial/surgery* | - |
dc.subject.MESH | Ovarian Neoplasms/blood | - |
dc.subject.MESH | Ovarian Neoplasms/pathology* | - |
dc.subject.MESH | Ovarian Neoplasms/surgery* | - |
dc.subject.MESH | Principal Component Analysis | - |
dc.subject.MESH | Reproducibility of Results | - |
dc.subject.MESH | Risk | - |
dc.subject.MESH | Tomography, X-Ray Computed | - |
dc.subject.MESH | Young Adult | - |
dc.title | Use of complex surgical procedures, patterns of tumor spread, and CA-125 predicts a risk of incomplete cytoreduction: A Korean Gynecologic Oncology Group study (KGOG-3022) | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Radiology (영상의학) | - |
dc.contributor.googleauthor | Dae Chul Jung | - |
dc.contributor.googleauthor | Sokbom Kang | - |
dc.contributor.googleauthor | Seung-Cheol Kim | - |
dc.contributor.googleauthor | Jae Weon Kim | - |
dc.contributor.googleauthor | Joo-Hyun Nam | - |
dc.contributor.googleauthor | Sang-Young Ryu | - |
dc.contributor.googleauthor | Seok Ju Seong | - |
dc.contributor.googleauthor | Byoung-Gie Kim | - |
dc.identifier.doi | 10.1016/j.ygyno.2013.07.110 | - |
dc.admin.author | false | - |
dc.admin.mapping | false | - |
dc.contributor.localId | A03592 | - |
dc.relation.journalcode | J00956 | - |
dc.identifier.eissn | 1095-6859 | - |
dc.identifier.pmid | 23954903 | - |
dc.identifier.url | http://www.sciencedirect.com/science/article/pii/S0090825813010755 | - |
dc.subject.keyword | Computed tomography | - |
dc.subject.keyword | Cytoreductive surgery | - |
dc.subject.keyword | Optimal cytoreduction | - |
dc.subject.keyword | Ovarian cancer | - |
dc.subject.keyword | Spread pattern | - |
dc.subject.keyword | Surgical skill index | - |
dc.contributor.alternativeName | Jung, Dae Chul | - |
dc.contributor.affiliatedAuthor | Jung, Dae Chul | - |
dc.rights.accessRights | not free | - |
dc.citation.volume | 131 | - |
dc.citation.number | 2 | - |
dc.citation.startPage | 336 | - |
dc.citation.endPage | 340 | - |
dc.identifier.bibliographicCitation | GYNECOLOGIC ONCOLOGY, Vol.131(2) : 336-340, 2013 | - |
dc.identifier.rimsid | 33339 | - |
dc.type.rims | ART | - |
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