Lin Junyi, Kong Jianbin, Luo Mingli, Shen Zefeng, Fang Shuogui, Hu Jintao, Xu Zixin, Dong Wen, Huang Jian, Lin Tianxin
Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.
Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.
J Clin Med. 2022 Jun 2;11(11):3188. doi: 10.3390/jcm11113188.
The existing studies on primary bladder lymphoma (PBL) are retrospective analyses based on individual cases or small series studies, and the research on PBL is not unified and in-depth enough at present because of the scarcity of PBL and the lack of relevant literature. This study is designed to develop and validate nomograms for overall survival (OS) and cancer-specific survival (CSS) prediction in patients with PBL.
According to the Surveillance, Epidemiology, and End Results (SEER) database, 405 patients diagnosed with PBL from 1975 to 2016 were collected and randomly assigned to training ( = 283) and validation ( = 122) cohort. After the multivariable Cox regression, the OS and CSS nomograms were developed. The discrimination, calibration and clinical usefulness of the nomograms were assessed and validated, respectively, by the training and validation cohort. Furthermore, all of the patients were reclassified into high- and low-risk groups and their survival were compared through Kaplan-Meier method and log-rank test.
Age, subtype, Ann Arbor stage, radiation and chemotherapy were identified as independent prognostic factors for OS and age, sex, and subtype for CSS, then corresponding nomograms predicting the 3- and 5-year survival were constructed. The presented nomograms demonstrated good discrimination and calibration, which the C-index in the training and validation cohort were 0.744 (95% confidence interval [CI], 0.705-0.783) and 0.675 (95% CI, 0.603-0.747) for OS nomogram and 0.692 (95% CI, 0.632-0.752) and 0.646 (95% CI, 0.549-0.743) for CSS nomogram, respectively. Furthermore, the nomograms can be used to effectively distinguish Patients with PBL at high risk of death. The clinical usefulness of the nomograms was visually displayed by decision curve analysis.
We updated the baseline characteristics of patients with PBL and constructed OS and CSS nomograms to predict their 3- and 5-year survival. Using these nomograms, it would be convenient to individually predict the prognosis of patients with PBL and provide guidance for clinical treatment.
目前关于原发性膀胱淋巴瘤（PBL）的研究多为基于个别病例的回顾性分析或小样本研究，由于PBL病例稀缺且相关文献匮乏，目前对PBL的研究不够统一和深入。本研究旨在开发并验证用于预测PBL患者总生存期（OS）和癌症特异性生存期（CSS）的列线图。
根据监测、流行病学和最终结果（SEER）数据库，收集1975年至2016年诊断为PBL的405例患者，并随机分为训练组（n = 283）和验证组（n = 122）。经过多变量Cox回归分析，构建了OS和CSS列线图。分别通过训练组和验证组评估并验证列线图的区分度、校准度和临床实用性。此外，将所有患者重新分为高风险组和低风险组，并通过Kaplan-Meier法和对数秩检验比较其生存率。
年龄、亚型、Ann Arbor分期、放疗和化疗被确定为OS的独立预后因素，年龄、性别和亚型为CSS的独立预后因素，然后构建了预测3年和5年生存率的相应列线图。所呈现的列线图显示出良好的区分度和校准度，OS列线图在训练组和验证组中的C指数分别为0.744（95%置信区间[CI]，0.705 - 0.783）和0.675（95%CI，0.603 - 0.747），CSS列线图分别为0.692（95%CI，0.632 - 0.752）和0.646（95%CI，0.549 - 0.743）。此外，列线图可有效区分死亡风险高的PBL患者。决策曲线分析直观地展示了列线图的临床实用性。
我们更新了PBL患者的基线特征，并构建了OS和CSS列线图以预测其3年和5年生存率。使用这些列线图，可方便地对PBL患者的预后进行个体化预测，并为临床治疗提供指导。
