Risk Factors And Prognostic Factors Of Distant Metastasis In Patients With Newly Diagnosed Ovarian Carcinosarcoma And The Establishment Of Nomogram Of Prediction Model

Purpose:Ovarian Carcinosarcoma(OCS)is a rare gynecological malignant tumor.Compared with other types of ovarian malignant tumors,OCS tends to occur in elderly women,and the prognosis of distant metastasis is poor.However,there is no research on the diagnosis and prognosis evaluation of distant metastasis in patients with ovarian cancer sarcoma.In this study,our aim is to analyze the incidence and related factors of distant metastasis of ovarian cancer sarcoma and the prognostic factors of patients with distant metastasis of ovarian cancer sarcoma at the population level based on SEER database.MethodsWe retrospectively extracted the data of patients with ovarian cancer sarcoma diagnosed in 2004-2015 from surveillance,epidemiology,and end results(SEER)database.Univariate and multivariate logistic regression analysis was used to identify the independent risk factors of distant metastasis of ovarian cancer sarcoma,and univariate and multivariate Cox regression analysis was used to determine the independent prognostic factors of distant metastasis of ovarian cancer sarcoma.Then,based on independent risk factors and prognosis factors,we established two nomograms to predict the risk of distant metastasis of ovarian cancer sarcoma and the prognosis of patients with distant metastasis of ovarian cancer sarcoma,and evaluated the performance of nomograms by calculating the receiver operating characteristic(ROC)curve and the Area Under Curve(AUC)and calibration curve.Result:In this study,920 cases of ovarian cancer sarcoma were included,of which226 cases had distant metastasis at the time of diagnosis.The independent risk factors of distant metastasis in patients with ovarian cancer sarcoma include race,tumor laterality,tumor size,T stage and N stage.Chemotherapy and age are independent prognostic factors for patients with distant metastasis of ovarian cancer sarcoma.The ROC curve and calibration curve in the training group and the verification group confirmed that the two nomograms can accurately predict the occurrence and prognosis of distant metastasis in patients with ovarian cancer sarcoma.ConclusionOur study confirmed that race,tumor laterality,tumor size,T stage and N stage are independent risk factors for distant metastasis of ovarian cancer sarcoma.Age and chemotherapy are independent prognostic factors of patients with distant metastasis of ovarian cancer sarcoma.The two nomograms developed based on independent risk factors and prognostic factors are expected to be an effective tool to predict the risk of distant metastasis of ovarian cancer sarcoma patients and the individualized prognosis of distant metastasis patients,which is helpful for clinical decision-making.