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Nomogram of Zivanovic et al for Predicting 5-Year Survival Following Resection of a Uterine Leiomyosarcoma

Purpose: To predict the 5-year survival for a woman with a uterine leiomyosarcoma based on the study of Zivanovic et al.

Description

Zivanovic et al used a nomogram to predict 5-year survival in a woman following resection of a uterine leiomyosarcoma. This can help to identify a patient who may benefit from a more aggressive or novel therapy. The authors are from Memorial Sloan-Kettering Cancer Center in New York City.


Parameters:

(1) age at diagnosis

(2) tumor diameter in cm

(3) tumor grade

(4) cervical involvement

(5) loco-regional metastases

(6) distant metastases

(7) mitotic index (mitoses in 10 high power fields or hpf; analyzed using log transformation)

 

points for age in years =

= (0.12 * (age)) - 2.4

 

points for tumor diameter in cm =

= MIN(28, (diameter in cm))

 

Mitotic Index

Points

1 to 4

(9.14 * (index)) - 9.1

4 to 20

(-0.0734 * ((index)^2)) + (3.446 * (index)) + 15.16

20 to 148

(-0.001962 * ((index)^2)) + (0.6013 * (index)) + 44.79

148 to 245

(0.103 * (index)) + 74.74

 

 

Parameter

Finding

Points

tumor grade

not high

0

 

high grade

66

cervical involvement

no

0

 

yes

15

loco-regional metastases

no

0

 

yes

56.5

distant metastases

no

0

 

yes

39

 

total score =

= SUM(points for all 7 parameters)

 

Interpretation:

• minimum score: 0

• maximum: up to 300

• The higher the score the worse the 5-year survival.

 

Total Score

Probability of 5-Year Survival

< 55

> 80%

55 to 152

(-0.001468 * ((score)^2)) - (0.1068 * (score)) + 90.24

152 to 234

(0.002147 * ((score)^2)) - (1.256 * (score)) + 181.4

> 234

< 5%

 


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Specialty

Objective

ICD-10