A Nomogram Model Construction for Predicting Recurrence and Progression in Locally Advanced Cervical Cancer After Definitive Chemoradiotherapy
ZHANG Miaoqin
LI Weihua
WEI Dan
QIU Lirong
WANG Junxia
ZHANG Junli
Abstract：Objective To explore the risk factors for recurrence and progression of locally advanced cervical cancer after radical chemoradiotherapy and to construct a nomogram prediction model,so as to provide references for treatment optimization and prognosis evaluation.Methods A total of 331 patients with locally advanced cervical cancer who received radical chemoradiotherapy in Yuncheng Central Hospital Affiliated to Shanxi Medical University from January 2019 to January 2022 were retrospectively included.Their clinicopathological characteristics and follow-up data were analyzed.Univariate and multivariate analyses were performed to identify risk factors for recurrence and progression of locally advanced cervical cancer after radical chemoradiotherapy.A nomogram prediction model was constructed and its predictive performance was analyzed.Results The median follow-up time of the 331 patients was 27.0(5.0-36.0)months.The 1-year and 3-year progression-free survival rates were 83.99%(278/331)and 67.67%(224/331),respectively.The 1-year and 3-year overall survival rates were 95.47%(316/331)and 77.34%(256/331),respectively.Univariate analysis showed that there were statistically significant differences in 3-year progression-free survival among subgroups in terms of histopathological differentiation,maximum primary tumor diameter,pelvic lymph node metastasis,depth of invasion,type of pelvic radiotherapy,squamous cell carcinoma antigen(SCC-Ag)level,and D-dimer level(P<0.05).Multivariate analysis showed that moderately to poorly differentiated histology,maximum primary tumor diameter≥4 cm,pelvic lymph node metastasis,depth of invasion over 1/2,whole pelvic radiotherapy,SCC-Ag>2.0 μg/L,and D-dimer>0.8 mg/L were independent risk factors for recurrence and progression of locally advanced cervical cancer after radical chemoradiotherapy(P<0.05).A nomogram model for recurrence and progression of locally advanced cervical cancer after radical chemoradiotherapy was constructed based on the multivariate analysis results.The areas under the ROC curve of this model for predicting 1-year,2-year,and 3-year progression-free survival were 0.729,0.761,and 0.773,respectively.Conclusion The recurrence and progression of locally advanced cervical cancer after radical chemoradiotherapy may be associated with multiple factors,including histopathological differentiation,maximum tumor diameter,pelvic lymph node metastasis,depth of invasion,pelvic radiotherapy type,SCC-Ag level,and D-dimer level.The nomogram model constructed based on these factors demonstrates good predictive performance for 1-year,2-year,and 3-year progression-free survival.
Keywords：locally advanced cervical cancerdefinitive chemoradiotherapyrecurrenceprogressionnomogram model
Publication Date：2026-01-20
Online Publishing Date：2026-01-24(First online date of this platform, not the publication date of the document)
Pages：7( 105-111 )