TY - JOUR
T1 - Proposed New Dynamic Prognostic Index for Diffuse Large B-Cell Lymphoma: International Metabolic Prognostic Index
T2 - International Metabolic Prognostic Index
AU - Mikhaeel, N. George
AU - Heymans, Martijn W.
AU - Eertink, Jakoba J.
AU - de Vet, Henrica C. W.
AU - Boellaard, Ronald
AU - Duhrsen, Ulrich
AU - Ceriani, Luca
AU - Schmitz, Christine
AU - Wiegers, Sanne E.
AU - Huttmann, Andreas
AU - Lugtenburg, Pieternella J.
AU - Zucca, Emanuele
AU - Zwezerijnen, Gerben J. C.
AU - Hoekstra, Otto S.
AU - Zijlstra, Josee M.
AU - Barrington, Sally F.
N1 - Funding Information: Concordance was higher for MTV (c-index = 0.650 and 0.667 for PFS and OS, respectively) than for IPI (c-index = 0.619 and 0.646, respectively). This is supported by their AIC values, which was lowest for MTV. Hence, MTV was a better predictor (Data Supplement). Publisher Copyright: © American Society of Clinical Oncology.
PY - 2022/7/20
Y1 - 2022/7/20
N2 - PURPOSEBaseline metabolic tumor volume (MTV) is a promising biomarker in diffuse large B-cell lymphoma (DLBCL). Our aims were to determine the best statistical relationship between MTV and survival and to compare MTV with the International Prognostic Index (IPI) and its individual components to derive the best prognostic model.METHODSPET scans and clinical data were included from five published studies in newly diagnosed diffuse large B-cell lymphoma. Transformations of MTV were compared with the primary end points of 3-year progression-free survival (PFS) and overall survival (OS) to derive the best relationship for further analyses. MTV was compared with IPI categories and individual components to derive the best model. Patients were grouped into three groups for survival analysis using Kaplan-Meier analysis; 10% at highest risk, 30% intermediate risk, and 60% lowest risk, corresponding with expected clinical outcome. Validation of the best model was performed using four studies as a test set and the fifth study for validation and repeated five times.RESULTSThe best relationship for MTV and survival was a linear spline model with one knot located at the median MTV value of 307.9 cm3. MTV was a better predictor than IPI for PFS and OS. The best model combined MTV with age as continuous variables and individual stage as I-IV. The MTV-age-stage model performed better than IPI and was also better at defining a high-risk group (3-year PFS 46.3% v 58.0% and 3-year OS 51.5% v 66.4% for the new model and IPI, respectively). A regression formula was derived to estimate individual patient survival probabilities.CONCLUSIONA new prognostic index is proposed using MTV, age, and stage, which outperforms IPI and enables individualized estimates of patient outcome.
AB - PURPOSEBaseline metabolic tumor volume (MTV) is a promising biomarker in diffuse large B-cell lymphoma (DLBCL). Our aims were to determine the best statistical relationship between MTV and survival and to compare MTV with the International Prognostic Index (IPI) and its individual components to derive the best prognostic model.METHODSPET scans and clinical data were included from five published studies in newly diagnosed diffuse large B-cell lymphoma. Transformations of MTV were compared with the primary end points of 3-year progression-free survival (PFS) and overall survival (OS) to derive the best relationship for further analyses. MTV was compared with IPI categories and individual components to derive the best model. Patients were grouped into three groups for survival analysis using Kaplan-Meier analysis; 10% at highest risk, 30% intermediate risk, and 60% lowest risk, corresponding with expected clinical outcome. Validation of the best model was performed using four studies as a test set and the fifth study for validation and repeated five times.RESULTSThe best relationship for MTV and survival was a linear spline model with one knot located at the median MTV value of 307.9 cm3. MTV was a better predictor than IPI for PFS and OS. The best model combined MTV with age as continuous variables and individual stage as I-IV. The MTV-age-stage model performed better than IPI and was also better at defining a high-risk group (3-year PFS 46.3% v 58.0% and 3-year OS 51.5% v 66.4% for the new model and IPI, respectively). A regression formula was derived to estimate individual patient survival probabilities.CONCLUSIONA new prognostic index is proposed using MTV, age, and stage, which outperforms IPI and enables individualized estimates of patient outcome.
UR - http://www.scopus.com/inward/record.url?scp=85134631917&partnerID=8YFLogxK
U2 - https://doi.org/10.1200/JCO.21.02063
DO - https://doi.org/10.1200/JCO.21.02063
M3 - Article
C2 - 35357901
SN - 0732-183X
VL - 40
SP - 2352-+
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 21
ER -