Development and validation of a nomogram to predict the risk of postmenopausal uterine leiomyoma degeneration: A retrospective study

Abstract

Abstract Objective: The aim of this study was to investigate the risk factors for postmenopausal uterine leiomyoma degeneration and to develop a nomogram for clinical risk assessment. Study design and setting: A total of 508 patients were enrolled from 1 August 2012 to 1 August 2022. Univariate and multivariate logistic regression models were used to analyse the association between variables and uterine leiomyoma degeneration in postmenopausal patients. A nomogram for uterine leiomyoma degeneration in postmenopausal patients was developed and validated by bootstrap resampling. The calibration curve was used to assess the accuracy of the model and the ROC, DCA and NRI were compared with the clinical experience model. Results: DM, breast cancer, number, size5, LDH, TG and Ca2+ were independent risk factors for uterine leiomyoma degeneration in postmenopausal patients. We developed a user-friendly nomogram which showed good diagnostic performance (AUC=0.714). The model was consistent and the calibration curve of our cohort was close to the ideal diagonal line. DCA indicated that the model has potential value for clinical application. Furthermore, our model was superior to the previous clinical experience model in terms of ROC (P=0.00039), DCA and NRI (NRI=0.4175722). Conclusions: We have developed a prediction nomogram for uterine leiomyoma degeneration in postmenopausal patients. This nomogram could serve as an important warning signal and evaluation method for the degeneration and malignant transformation of uterine leiomyoma in postmenopausal patients.