Department of Radiation Oncology, Cancer Hospital and Institute, Peking Union Medical College (PUMC) and Chinese Academy of Medical Sciences (CAMS), Beijing, People's Republic of China.
Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China.
Leukemia. 2015 Jul;29(7):1571-7. doi: 10.1038/leu.2015.44. Epub 2015 Feb 20.
The aim of this study was to develop a widely accepted prognostic nomogram for extranodal NK/T-cell lymphoma, nasal-type (NKTCL). The clinical data from 1383 patients with NKTCL treated at 10 participating institutions between 2000 and 2011 were reviewed. A nomogram was developed that predicted overall survival (OS) based on the Cox proportional hazards model. To contrast the utility of the nomogram against the widely used Ann Arbor staging system, the International Prognostic Index (IPI) and the Korean Prognostic Index (KPI), we used the concordance index (C-index) and a calibration curve to determine its predictive and discriminatory capacity. The 5-year OS rate was 60.3% for the entire group. The nomogram included five important variables based on a multivariate analysis of the primary cohort: stage; age; Eastern Cooperative Oncology Group performance status; lactate dehydrogenase; and primary tumor invasion. The calibration curve showed that the nomogram was able to predict 5-year OS accurately. The C-index of the nomogram for OS prediction was 0.72 for both cohorts, which was superior to the predictive power (range, 0.56-0.64) of the Ann Arbor stage, IPI and KPI in the primary and validation cohorts. The proposed nomogram provides an individualized risk estimate of OS in patients with NKTCL.
本研究旨在为结外 NK/T 细胞淋巴瘤,鼻型(NKTCL)开发一种广泛认可的预后列线图。对 2000 年至 2011 年 10 家参与机构治疗的 1383 例 NKTCL 患者的临床资料进行了回顾性分析。基于 Cox 比例风险模型,建立了一个预测总生存期(OS)的列线图。为了对比该列线图与广泛使用的 Ann Arbor 分期系统、国际预后指数(IPI)和韩国预后指数(KPI)的效用,我们使用一致性指数(C-index)和校准曲线来确定其预测和区分能力。整个队列的 5 年 OS 率为 60.3%。该列线图基于对主要队列的多变量分析,包括五个重要变量:分期;年龄;东部合作肿瘤学组体能状态;乳酸脱氢酶;以及原发肿瘤浸润。校准曲线表明,该列线图能够准确预测 5 年 OS。该列线图对 OS 预测的 C-index 在两个队列中均为 0.72,优于 Ann Arbor 分期、IPI 和 KPI 在主要和验证队列中的预测能力(范围为 0.56-0.64)。所提出的列线图为 NKTCL 患者提供了个体化的 OS 风险估计。