Published online Mar 6, 2022. doi: 10.12998/wjcc.v10.i7.2115
Peer-review started: November 29, 2021
First decision: January 12, 2022
Revised: January 17, 2022
Accepted: February 23, 2022
Article in press: February 23, 2022
Published online: March 6, 2022
Processing time: 92 Days and 21.5 Hours
The prognosis of borderline ovarian tumors (BOTs) has been the concern of clinicians and patients. It is urgent to develop a model to predict the survival of patients with BOTs.
To construct a nomogram to predict the likelihood of overall survival (OS) in patients with BOTs.
A total of 192 patients with histologically verified BOTs and 374 patients with epithelial ovarian cancer (EOC) were retrospectively investigated for clinical characteristics and survival outcomes. A 1:1 propensity score matching (PSM) analysis was performed to eliminate selection bias. Survival was analyzed by using the log-rank test and the restricted mean survival time (RMST). Next, univariate and multivariate Cox regression analyses were used to identify meaningful independent prognostic factors. In addition, a nomogram model was developed to predict the 1-, 3-, and 5-year overall survival of patients with BOTs. The predictive performance of the model was assessed by using the concordance index (C-index), calibration curves, and decision curve analysis (DCA).
For clinical data, there was no significant difference in body mass index, preoperative CA199 concentration, or tumor localization between the BOTs group and EOC group. Women with BOTs were significantly younger than those with EOC. There was a significant difference in menopausal status, parity, preoperative serum CA125 concentration, Federation International of gynecology and obstetrics (FIGO) stage, and whether patients accepted postoperative adjuvant therapy between the BOT and EOC group. After PSM, patients with BOTs had better overall survival than patients with EOC (P value = 0.0067); more importantly, the 5-year RMST of BOTs was longer than that of EOC (P value = 0.0002, 95%CI
Patients with BOTs had a better prognosis than patients with EOC. The nomogram we constructed might be helpful for clinicians in personalized treatment planning and patient counseling.
Core Tip: The recurrence and overall survival of borderline ovarian tumors (BOTs) after operation have been one of the main concerns of patients and clinicians. In this research, we firstly performed a 1:1 propensity score matching analysis by applying age as a matching variable, then we found that patients with BOTs had a better overall survival as compared to patients with epithelial ovarian cancer (EOC), more importantly, the 5-year restricted mean survival time of BOTs was longer than EOC. What’s more, we conducted a nomogram that could accurately predict 1, 3, 5-year overall survival in patients with BOTs.