World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access
Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc
Journal website https://wjon.elmerpub.com

Original Article

Volume 16, Number 3, June 2025, pages 317-330

Nomograms for Predicting Overall Survival and Cancer-Specific Survival of Small Cell Carcinoma of Ovary Patients: A Retrospective Cohort Study

Figures

↓  Figure 1. Optimal cutoff values for age, year of diagnosis, and tumor size using X-tile software analysis. (a, b) The optimal cutoff values of the variable age were 45 and 72 years. (c, d) The optimal cutoff values of the variable year of diagnosis were 2002 and 2015. (e, f) The optimal cutoff values of tumor size were 92 and 141 mm.
Figure 1.
↓  Figure 2. Nomograms for predicting 1-, 3-, and 5-year survival of SCCO patients: (a) overall survival; (b) cancer-specific survival. SCCO: small cell carcinoma of ovary; FIGO: Federation International of Gynecology and Obstetrics.
Figure 2.
↓  Figure 3. ROC curve of the nomogram (a) and FIGO stage (c) for OS. ROC curve of the nomogram (b) and FIGO stage (d) for CSS. CSS: cancer-specific survival; FIGO: Federation International of Gynecology and Obstetrics; OS: overall survival; ROC: receiver operating characteristic.
Figure 3.
↓  Figure 4. Calibration curves for 1-year (a), 3-year (b), and 5-year (c) OS. Calibration curves for 1-year (d), 3-year (e), and 5-year (f) CSS. CSS: cancer-specific survival; OS: overall survival.
Figure 4.
↓  Figure 5. DCA curve of the nomogram and FIGO stage for OS (a) and CSS (b). CSS: cancer-specific survival; DCA: decision curve analysis; FIGO: Federation International of Gynecology and Obstetrics; OS: overall survival.
Figure 5.

Tables

↓  Table 1. Characteristics of Small Cell Carcinoma of Ovary Patients
 
Characteristics Patients, N (%) Deaths, N (%) Cancer-specific deaths, N (%)
Numbers in parentheses for all variables represent column percentages. CA125: serum carbohydrate antigen 125; DSW: divorced, separated, or widowed; FIGO: Federation International of Gynecology and Obstetrics.
Total 236 173 166
Age (years)
  ≤ 45 145 (61.44) 94 (54.34) 90 (54.22)
  46 - 72 63 (26.69) 52 (30.06) 50 (30.12)
  ≥ 73 28 (11.86) 27 (15.61) 26 (15.66)
Marital status at diagnosis
  Single 106 (44.92) 69 (39.88) 65 (39.16)
  Married 88 (37.29) 69 (39.88) 66 (39.76)
  DSW 34 (14.41) 30 (17.34) 30 (18.07)
  Unknown 8 (3.39) 5 (2.89) 5 (3.01)
Median household income ($)
  < 55,000 42 (17.80) 39 (22.54) 38 (22.89)
  55,000 - 69,999 81 (34.32) 56 (32.37) 55 (33.13)
  ≥ 70,000 113 (47.88) 78 (45.09) 73 (43.98)
Race
  Non-Hispanic Black 16 (6.78) 13 (7.51) 11 (6.63)
  Non-Hispanic White 151 (63.98) 110 (63.58) 105 (63.25)
  Non-Hispanic Asian/Pacific Islander 23 (9.75) 15 (8.67) 15 (9.04)
  Non-Hispanic American Indian/Alaska Native 4 (1.69) 2 (1.16) 2 (1.2)
  Hispanic 41 (17.37) 33 (19.08) 33 (19.88)
  Non-Hispanic unknown race 1 (0.42) 0 (0) 0 (0)
Year of diagnosis
  2000 - 2002 33 (13.98) 26 (15.03) 21 (12.65)
  2003 - 2015 140 (59.32) 107 (61.85) 107 (64.46)
  2016 - 2020 63 (26.69) 40 (23.12) 38 (22.89)
Laterality
  Bilateral 30 (12.71) 27 (15.61) 26 (15.66)
  Right 96 (40.68) 64 (36.99) 62 (37.35)
  Left 84 (35.59) 56 (32.37) 54 (32.53)
  Paired site, but no information concerning laterality 23 (9.75) 23 (13.29) 21 (12.65)
  Only one side - side unspecified 3 (1.27) 3 (1.73) 3 (1.81)
Tumor size (mm)
  ≤ 92 37 (15.68) 29 (16.76) 29 (17.47)
  93 - 141 41 (17.37) 33 (19.08) 33 (19.88)
  ≥ 142 79 (33.47) 44 (25.43) 43 (25.90)
  Unknown 79 (33.47) 67 (38.73) 61 (36.75)
Surgery status
  No surgery 52 (22.03) 51 (29.48) 47 (28.31)
  Surgery 184 (77.97) 122 (70.52) 119 (71.69)
Chemotherapy status
  No chemotherapy/unknown 55 (23.31) 48 (27.75) 46 (27.71)
  Chemotherapy 181 (76.69) 125 (72.25) 120 (72.29)
Radiation therapy
  No radiation/unknown 211 (89.41) 161 (93.06) 155 (93.37)
  Radiation 25 (10.59) 12 (6.94) 11 (6.63)
Grade
  I/II 2 (0.85) 1 (0.58) 1 (0.60)
  III/IV 112 (47.46) 80 (46.24) 77 (46.39)
  Unknown 122 (51.69) 92 (53.18) 88 (53.01)
FIGO stage
  I 53 (22.46) 21 (12.14) 20 (12.05)
  II 17 (7.20) 13 (7.51) 13 (7.83)
  III 78 (33.05) 64 (36.99) 60 (36.14)
  IV 73 (30.93) 64 (36.99) 62 (37.35)
  Unknown 15 (6.36) 11 (6.36) 11 (6.63)
Lymph nodes status
  Negative 64 (27.12) 32 (18.50) 31 (18.67)
  Positive 46 (19.49) 30 (17.34) 30 (18.07)
  Unknown 126 (53.39) 111 (64.16) 105 (63.25)
CA125
  Negative 9 (3.81) 3 (1.73) 3 (1.81)
  Positive 82 (34.75) 55 (31.79) 54 (32.53)
  Unknown 145 (61.44) 115 (66.47) 109 (65.66)
Number of primary tumors
  First of two or more primaries 14 (5.93) 8 (4.62) 5 (3.01)
  One primary only 222 (94.07) 165 (95.38) 161 (96.99)

 

↓  Table 2. Univariable Cox Regression for Analyzing the Associated Factors for Small Cell Carcinoma of Ovary
 
Characteristics OS CSS
HR (95% CI) P HR (95% CI) P
CA125: serum carbohydrate antigen 125; CI: confidence interval; CSS: cancer-specific survival; DSW: divorced, separated, or widowed; FIGO: Federation International of Gynecology and Obstetrics; HR: hazard ratio; OS: overall survival.
Age (years)
  ≤ 45 Reference Reference
  46 - 72 1.75 (1.25 - 2.46) 0.001 1.76 (1.25 - 2.49) 0.001
  ≥ 73 6.77 (4.34 - 10.56) < 0.001 6.73 (4.28 - 10.58) < 0.001
Marital status at diagnosis
  DSW Reference Reference
  Married 0.62 (0.41 - 0.96) 0.032 0.60 (0.39 - 0.92) 0.019
  Single 0.45 (0.29 - 0.69) < 0.001 0.42 (0.27 - 0.65) < 0.001
  Unknown 0.54 (0.21 - 1.39) 0.202 0.55 (0.21 - 1.41) 0.210
Median household income ($)
  < 55,000 Reference Reference
  55,000 - 69,999 0.57 (0.38 - 0.86) 0.007 0.58 (0.38 - 0.88) 0.011
  ≥ 70,000 0.64 (0.44 - 0.95) 0.025 0.63 (0.42 - 0.93) 0.021
Race
  Non-Hispanic Black Reference Reference
  Non-Hispanic White 0.88 (0.50 - 1.57) 0.667 1.00 (0.54 - 1.87) 0.993
  Non-Hispanic Asian/Pacific Islander 0.81 (0.38 - 1.70) 0.574 0.96 (0.44 - 2.09) 0.913
  Non-Hispanic American Indian/Alaska Native 2.37 (0.53 - 10.70) 0.260 2.78 (0.61 - 12.78) 0.188
  Hispanic 1.16 (0.61 - 2.20) 0.660 1.36 (0.68 - 2.68) 0.383
  Non-Hispanic unknown race NA NA
Year of diagnosis
  2000 - 2002 Reference Reference
  2003 - 2015 1.28 (0.83 - 1.97) 0.262 1.55 (0.97 - 2.48) 0.065
  2016 - 2020 1.38 (0.84 - 2.28) 0.203 1.57 (0.92 - 2.69) 0.098
Laterality
  Bilateral Reference Reference
  Right 0.48 (0.31 - 0.76) 0.002 0.50 (0.31 - 0.79) 0.003
  Left 0.50 (0.31 - 0.79) 0.003 0.51 (0.32 - 0.81) 0.005
  Paired site, but no information concerning laterality 2.05 (1.16 - 3.60) 0.013 1.93 (1.08 - 3.45) 0.028
  Only one side - side unspecified 9.39 (2.69 - 32.71) < 0.001 9.87 (2.82 - 34.55) < 0.001
Tumor size (mm)
  ≤ 92 Reference Reference
  93 - 141 0.77 (0.47 - 1.27) 0.302 0.76 (0.46 - 1.26) 0.293
  ≥ 142 0.45 (0.28 - 0.72) < 0.001 0.44 (0.27 - 0.71) < 0.001
  Unknown 0.90 (0.58 - 1.40) 0.646 0.83 (0.53 - 1.29) 0.400
Surgery status
  No surgery Reference Reference
  Surgery 0.23 (0.17 - 0.33) < 0.001 0.25 (0.18 - 0.36) < 0.001
Chemotherapy status
  No chemotherapy/unknown Reference Reference
  Chemotherapy 0.38 (0.27 - 0.53) < 0.001 0.38 (0.27 - 0.53) < 0.001
Radiation therapy
  No radiation/unknown Reference Reference
  Radiation 0.51 (0.29 - 0.92) 0.026 0.49 (0.26 - 0.90) 0.021
Grade
  I/II Reference Reference
  III/IV 1.33 (0.18 - 9.57) 0.777 1.30 (0.18 - 9.38) 0.792
  Unknown 1.76 (0.24 - 12.62) 0.575 1.69 (0.24 - 12.17) 0.601
FIGO stage
  I Reference Reference
  II 2.78 (1.39 - 5.57) 0.004 2.88 (1.43 - 5.81) 0.003
  III 3.79 (2.30 - 6.22) < 0.001 3.66 (2.20 - 6.09) < 0.001
  IV 5.77 (3.50 - 9.51) < 0.001 5.83 (3.50 - 9.72) < 0.001
  Unknown 3.89 (1.87 - 8.10) < 0.001 3.97 (1.89 - 8.31) < 0.001
Lymph nodes status
  Negative Reference Reference
  Positive 1.95 (1.18 - 3.21) 0.009 1.98 (1.20 - 3.28) 0.008
  Unknown 3.44 (2.31 - 5.13) < 0.001 3.31 (2.21 - 4.96) < 0.001
CA125
  Negative Reference Reference
  Positive 3.02 (0.94 - 9.67) 0.062 2.95 (0.92 - 9.46) 0.068
  Unknown 2.89 (0.92 - 9.10) 0.070 2.77 (0.88 - 8.72) 0.082
Number of primary tumors
  First of two or more primaries Reference Reference
  One primary only 1.94 (0.95 - 3.97) 0.068 2.92 (1.19 - 7.12) 0.019

 

↓  Table 3. Multivariable Cox Regression for Analyzing the Associated Factors for Small Cell Carcinoma of Ovary
 
Characteristics OS CSS
HR (95% CI) P HR (95% CI) P
CI: confidence interval; CSS: cancer-specific survival; DSW: divorced, separated, or widowed; FIGO: Federation International of Gynecology and Obstetrics; HR: hazard ratio; OS: overall survival.
Age (years)
  ≤ 45 Reference Reference
  46 - 72 0.92 (0.59 - 1.44) 0.709 0.90 (0.57 - 1.43) 0.663
  ≥ 73 3.30 (1.63 - 6.68) < 0.001 3.28 (1.55 - 6.94) 0.002
Marital status at diagnosis
  DSW Reference Reference
  Married 1.48 (0.81 - 2.71) 0.207 1.44 (0.77 - 2.68) 0.251
  Single 1.43 (0.78 - 2.65) 0.251 1.44 (0.77 - 2.68) 0.254
  Unknown 1.29 (0.44 - 3.79) 0.645 1.16 (0.39 - 3.47) 0.788
Median household income ($)
  < 55,000 Reference Reference
  55,000 - 69,999 0.46 (0.30 - 0.72) < 0.001 0.52 (0.34 - 0.81) 0.004
  ≥ 70,000 0.65 (0.43 - 0.99) 0.044 0.70 (0.46 - 1.08) 0.109
Laterality
  Bilateral Reference Reference
  Right 0.78 (0.47 - 1.29) 0.335 0.82 (0.49 - 1.38) 0.462
  Left 0.70 (0.42 - 1.15) 0.159 0.74 (0.45 - 1.23) 0.251
  Paired site, but no information concerning laterality 0.90 (0.46 - 1.77) 0.768 0.95 (0.47 - 1.92) 0.891
  Only one side - side unspecified 5.26 (1.36 - 20.32) 0.016 5.68 (1.45 - 22.21) 0.012
Tumor size (mm)
  ≤ 92 Reference Reference
  93 - 141 0.85 (0.49 - 1.50) 0.584 0.83 (0.46 - 1.47) 0.517
  ≥ 142 0.83 (0.49 - 1.40) 0.478 0.71 (0.41 - 1.22) 0.215
  Unknown 0.79 (0.48 - 1.31) 0.363 0.71 (0.42 - 1.21) 0.205
Surgery status
  No surgery Reference Reference
  Surgery 0.43 (0.26 - 0.71) < 0.001 0.44 (0.26 - 0.73) 0.002
Chemotherapy status
  No chemotherapy/unknown Reference Reference
  Chemotherapy 0.33 (0.22 - 0.50) < 0.001 0.35 (0.23 - 0.53) < 0.001
Radiation therapy
  No radiation/unknown Reference Reference
  Radiation 0.58 (0.30 - 1.10) 0.097 0.49 (0.25 - 0.96) 0.038
Grade
  I/II Reference Reference
  III/IV 0.82 (0.10 - 6.59) 0.854 0.79 (0.10 - 6.28) 0.820
  Unknown 1.01 (0.12 - 8.25) 0.992 0.86 (0.10 - 7.01) 0.886
FIGO stage
  I Reference Reference
  II 2.33 (1.11 - 4.86) 0.025 2.44 (1.16 - 5.12) 0.019
  III 4.39 (2.51 - 7.66) < 0.001 4.03 (2.26 - 7.18) < 0.001
  IV 3.95 (2.06 - 7.57) < 0.001 4.54 (2.33 - 8.86) < 0.001
  Unknown 3.28 (1.45 - 7.40) 0.004 3.53 (1.54 - 8.06) 0.003
Lymph nodes status
  Negative Reference Reference
  Positive 0.76 (0.42 - 1.39) 0.377 0.78 (0.43 - 1.42) 0.415
  Unknown 1.27 (0.78 - 2.07) 0.339 1.14 (0.69 - 1.89) 0.613
Number of primary tumors
  First of two or more primaries Reference
  One primary only 3.79 (1.48 - 9.68) 0.005