4. Discussion
ovarian cancer, gynecologic malignancies, gynecological recurrent cancer
OVARIAN CANCER, ADVANCED CANCER
Clinical treatment of gynecological recurrent cancer and advanced cancer is very limited. Recently, with the deepening of collaboration of multidisciplinary technology, PE combined with organ function reconstruction has been gradually applied clinically by some doctors in gynecologic malignancies [It could be summarized that the majority of overall cases in this study are advanced-stage serous OC patients with treatment of PPE and chemotherapy. It is consistent with some reports that PPE was the most common type of PE and chemotherapy was usually recommended to patients after PE treatment regardless of its uncertain effects [Regarding lymph status, LNR and LODDS have been recently proposed as alternative index for assessing lymph node status in ovarian cancer [Subsequently, a prognostic nomogram model was established for EOC patients with PE treatment based on the selected clinical and pathological factors. Nomograms allow wide application in clinical practice by providing a simplified representation of a complicated statistical model utilizing a user-friendly graphical interface. In this constructed nomogram, patients being more than 70 years old, mucinous histologic type, FIGO stage III/IV, ≥9 examined lymph nodes, and 1-12 positive lymph nodes contributed to high scores, which indicate the low survival probability. In accordance with HR results, the FIGO stage and histological type showed the greatest discriminating power when compared with other variables. Based on the results of the ROC curve and Kaplan–Meier curve, it can be concluded that the nomogram exhibited excellent performance of discrimination in both the training and validation cohorts. As such, this new nomogram model can be used to identify high-risk EOC patients after PE treatment. Furthermore, in internal validation, when the nomogram was applied to the training and validation cohorts, the Cindex and calibration curve indicated decent clinical predictive accuracy, reliability, and repeatability. The results of DCA in our study proved that, compared with the FIGO staging, a constructed nomogram was a well-performing model in clinical applicability. Our nomogram is the first nomogram that is specifically applied to OC patients with PE treatment. Meanwhile, compared to reported studies of OC patients, all variables included in our nomograms are objective and not affected by the subjective evaluation of doctors and the individual feelings of patients [