Predicting outcomes in locally advanced cervical cancer treated with radiotherapy: a systematic review of nomograms
Year: 2026
Type: review
Study design: Systematic Review
Abstract: Objective: To systematically evaluate published nomograms developed for patients with locally advanced cervical cancer (LACC) treated with radiotherapy, focusing on prognostic performance, core predictive variables, and implications for future model development. Methods: A systematic literature search of PubMed, Embase, Scopus, Web of Science, and the Cochrane Library identified studies published between 2010 and 2025 that developed new nomograms for LACC cohorts treated with radiotherapy or chemoradiotherapy. Data extraction included study population, predicted outcomes (overall survival [OS], progression-free survival [PFS], or disease-free survival [DFS]), model performance (C-index), validation methods, calibration, and predictor variables. Predictor patterns were summarized primarily by frequency of inclusion across nomograms, with β-coefficients used only for exploratory within-model descriptions. Results: Nine studies met the inclusion criteria; eight developed nomograms for OS and three evaluated disease progression outcomes (PFS or DFS), with two studies evaluating both outcome categories. Reported C-indices ranged from 0.68 to 0.835, indicating moderate to good discrimination. Lymph node status, FIGO stage, and tumor size were among the most frequently incorporated predictors, while histology and SCC-Ag were also recurrently included. Validation in independent cohorts remained limited. Graphical calibration was commonly reported, whereas quantitative calibration measures and decision-curve analyses were inconsistently reported. Conclusions: Nomograms for LACC treated with radiotherapy generally demonstrate moderate-to-good discriminative performance and frequently incorporate lymph node status, stage, and tumor size. However, methodological heterogeneity, incomplete validation, and evolving treatment paradigms limit their immediate generalizability. Future work should focus on robust external validation, recalibration, and evaluation in contemporary treatment cohorts before clinical implementation.
Source: Frontiers in Oncology
Authors: Jaekyung Bae, Uisuk Kim, Sokbom Kang
Institutions: National Cancer Center, National Cancer Center
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7223177630