Comprehensive Assessment of Postoperative Recurrence and Survival in Patients with Cervical Cancer: Nomograms

Abstract

Abstract Background To investigate the value of nomograms based on clinical parameters, inflammatory indicators, intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) and MRI-derived radiomics in predicting recurrence-free survival (RFS), disease-free survival (DFS), cancer-specific survival (CSS) and overall survival (OS) in cervical cancer patients after surgery.Methods A retrospective analysis of 181 cervical cancer patients operated at our hospital between January 2015 and January 2021 with continuous follow-up was completed. The parameters of IVIM-DWI and radiomics were measured, analyzed and screened. The logistic regression with LASSO regularization was used to calculate radiomics score (Rad-score). Multivariate Cox regression analysis was used to construct nomogram models for predicting postoperative RFS, DFS, CSS and OS in cervical cancer patients, with internal and external validation.Results Clinical stage, parametrial infiltration, internal irradiation, D-value and Rad-score were independent prognostic factors for RFS; Squamous cell carcinoma antigen, internal irradiation, D-value, f-value and Rad-score were independent prognostic factors for DFS; Maximum tumor diameter, lymph node metastasis, platelets, D-value and Rad-score were independent prognostic factors for CSS; Lymph node metastasis, systemic inflammation response index, D-value and Rad-score were independent prognostic factors for OS. The AUCs of each model predicting RFS, DFS, CSS and OS at 1, 3 and 5 years were 0.985, 0.929, 0.910 and 0.833, 0.818, 0.816 and 0.832, 0.863, 0.891 and 0.804, 0.812, 0.870, respectively.Conclusions Nomograms based on clinical and imaging parameters showed high clinical value in predicting postoperative RFS, DFS, CSS and OS of cervical cancer patients and can be used as prognostic markers.