3581 - Comprehensive Evaluation of the Prognostic Value of Hematological Parameters, Nutritional Status Indices and Serum Tumor Markers in Patients with Locally Advanced Cervical Cancer: A Retrospective Stud

S. Wang¹, M. Zhao¹, Z. Gao², X. Yang³, Y. Wang⁴, K. Hua⁵, and J. Fu³; ¹Department of Radiation Oncology, Shanghai Sixth Peoples Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China, ²Shanghai Sixth Peoples Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, Shanghai, China, ³Shanghai Sixth Peoples Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China, ⁴Department of Gynecologic Oncology the International Peace Maternity and Child Health Hospital School of Medicine, Shanghai Jiao Tong University, Shanghai, China, ⁵Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China

Purpose/Objective(s): We aimed to investigated the prognostic implications associated with hematological parameters, nutritional status indices and serum tumor markers and ultimately developed a novel nomogram based on these selected prognostic factors in LACC patients treated with radiotherapy. Materials/

Methods: This retrospective study analyzed clinical data collected from our institute encompassing 375 patients diagnosed with cervical cancer at IFGO stages IB2-IVA between 2010 and 2020. Clinical and morphologic parameters, hematological parameters, nutritional status indicators, and serum tumor markers levels were systematically recorded. Enrolled patients were randomly divided into training and validation cohorts. Univariate, multivariate, and LASSO Cox regression analyses were used to identify independent prognostic factors. Based on the identified prognostic factors, the nomogram was developed and verified to predict the 3-, 4-, and 5-year OS of patients with LACC. The discrimination and calibration of the nomogram were assessed using the C-index value, ROC curve, AUC values and the calibration curve. DCA, IDI and NRI were used to assess the clinical utility of the nomogram.

Results: The study comprised 375 LACC patients with a median follow-up of 50 months. The 3-, 4-, and 5-year overall survival rates were 86.9%, 83.6%, and 76.4%, respectively. The enrolled patients were randomly divided into the training cohort (251 cases) and the validation cohort (124 cases) at a ratio of 2:1. Basophil percentage, PLR, CA153, SCC, COUNT, histological subtypes and FIGO stage were ultimately selected to construct the nomogram. The newly developed nomogram demonstrated predictive performance. The AUC values at 3-, 4-, and 5-year were 0.77, 0.79, and 0.77 in the training cohort and 0.62, 0.68, and 0.72 in the validation cohort, respectively. Calibration curves demonstrated satisfactory concordance between predicted survival probabilities and actual observations. ROC curves, C-index value, IDI, NRI, and DCA collectively indicated the superiority of the nomogram over the existing FIGO staging system.

Conclusion: This study developed a novel nomogram based on the hematological parameters (eosinophils percentage, PLR), nutritional status indices (CONUT) and Serum tumor markers (SCC, CA153) apart from traditional clinical and morphologic factors (FIGO stage, histologic type), which can accurately predict probabilities of OS in patients with LACC compared with traditional FIGO staging system. Monitoring and assessing these clinical features can help clinicians better stratify patients, conduct personalized survival assessment and develop reasonable individualized therapeutic regimens.