Bettini R, Tonolini M, Maccianti E
Divisione di Medicina Generale, Ospedale F. Del Ponte, Varese, Italy.
Haematologica. 1997 May-Jun;82(3):324-7.
In recent years, two predictive equations to estimate median expected survival at diagnosis for patients affected with Hodgkin's disease have been developed at the University of Pavia Medical School. The present retrospective work was aimed at testing correlation between mean survival estimated using the two equations and observed survival, and at comparing the results of the two different equations.
Fifty-three deceased patients were considered from a series of 114 consecutive ones. All these patients had been treated in a conventional way according to therapeutic modalities similar to those used in the series from which the two equations were derived. Expected median survival values calculated with the older, linear equation and with the newer exponential one were compared with observed survival.
Mean survival of the whole series was over 24 years, with survival probabilities of 85% after 5 years and 74% after 10 years. Using the first predictive equation on the 53 deceased patients resulted in a satisfactory correlation between estimated median survival and real survival: Pearson's R correlation coefficient value is 0.5996, with a t value of 5.35 and p < 0.001. The more recent exponential predictive equation showed a better correlation between estimated median survival and observed survival: R = 0.7338, t = 7.71, p < 0.001.
The new exponential equation, while apparently complex, is superior to the older one, and is a very reliable and straightforward tool for estimating median expected survival: its forecast proves to be an important pretreatment parameter in every HD patient. These observations support widespread use of this tool in clinical practice to evaluate the prognosis of Hodgkin patients in a more accurate and flexible way.
近年来,帕维亚大学医学院已开发出两种预测方程,用于估计霍奇金病患者诊断时的预期中位生存期。本回顾性研究旨在检验使用这两种方程估算的平均生存期与观察到的生存期之间的相关性,并比较这两种不同方程的结果。
从连续的114例患者中选取53例已故患者。所有这些患者均按照与推导这两种方程的系列研究中使用的治疗方式相似的传统方式进行治疗。将用较旧的线性方程和较新的指数方程计算出的预期中位生存值与观察到的生存期进行比较。
整个系列的平均生存期超过24年,5年后的生存概率为85%,10年后为74%。对53例已故患者使用第一个预测方程,得出估计的中位生存期与实际生存期之间具有令人满意的相关性:皮尔逊R相关系数值为0.5996,t值为5.35,p<0.001。最新的指数预测方程显示估计的中位生存期与观察到的生存期之间具有更好的相关性:R=0.7338,t=7.71,p<0.001。
新的指数方程虽然表面上较为复杂,但优于旧方程,是一种非常可靠且直接的估计预期中位生存期的工具:其预测结果被证明是每位霍奇金病患者重要的预处理参数。这些观察结果支持在临床实践中广泛使用该工具,以更准确、灵活地评估霍奇金病患者的预后。