Hugo J A Adams1, John M H de Klerk2, Rob Fijnheer3, Stefan V Dubois4, Rutger A J Nievelstein5, Thomas C Kwee5. 1. Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: h.j.a.adams@gmail.com. 2. Department of Nuclear Medicine, Meander Medical Center, Amersfoort, The Netherlands. 3. Department of Hematology, Meander Medical Center, Amersfoort, The Netherlands. 4. Department of Pathology, Meander Medical Center, Amersfoort, The Netherlands. 5. Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
Abstract
OBJECTIVE: To determine the prognostic value of tumor necrosis at computed tomography (CT) in newly diagnosed diffuse large B-cell lymphoma (DLBCL). MATERIALS AND METHODS: This retrospective study included 51 patients with newly diagnosed DLBCL who had undergone both unenhanced and intravenous contrast-enhanced CT before R-CHOP (rituximab, cyclophosphamide, hydroxydaunorubicin, oncovin and prednisolone) chemo-immunotherapy. Presence of tumor necrosis was visually and quantitatively assessed at CT. Associations between tumor necrosis status at CT and the National Comprehensive Cancer Network (NCCN) International Prognostic Index (IPI) factors were assessed. Cox regression analysis was used to determine the prognostic impact of NCCN-IPI scores and tumor necrosis status at CT. RESULTS: There were no correlations between tumor necrosis status at CT and the NCCN-IPI factors categorized age (ρ=-0.042, P=0.765), categorized lactate dehydrogenase (LDH) ratio (ρ=0.201, P=0.156), extranodal disease in major organs (φ=-0.245, P=0.083), Ann Arbor stage III/IV disease (φ=-0.208, P=0.141), and Eastern Cooperative Oncology Group (ECOG) performance status (φ=0.015, P=0.914). In the multivariate Cox proportional hazards model, only tumor necrosis status at CT was an independent predictive factor of progression-free survival (P=0.003) and overall survival (P=0.004). CONCLUSION: The findings of this study indicate the prognostic potential of tumor necrosis at CT in newly diagnosed DLBCL.
OBJECTIVE: To determine the prognostic value of tumor necrosis at computed tomography (CT) in newly diagnosed diffuse large B-cell lymphoma (DLBCL). MATERIALS AND METHODS: This retrospective study included 51 patients with newly diagnosed DLBCL who had undergone both unenhanced and intravenous contrast-enhanced CT before R-CHOP (rituximab, cyclophosphamide, hydroxydaunorubicin, oncovin and prednisolone) chemo-immunotherapy. Presence of tumor necrosis was visually and quantitatively assessed at CT. Associations between tumor necrosis status at CT and the National Comprehensive Cancer Network (NCCN) International Prognostic Index (IPI) factors were assessed. Cox regression analysis was used to determine the prognostic impact of NCCN-IPI scores and tumor necrosis status at CT. RESULTS: There were no correlations between tumor necrosis status at CT and the NCCN-IPI factors categorized age (ρ=-0.042, P=0.765), categorized lactate dehydrogenase (LDH) ratio (ρ=0.201, P=0.156), extranodal disease in major organs (φ=-0.245, P=0.083), Ann Arbor stage III/IV disease (φ=-0.208, P=0.141), and Eastern Cooperative Oncology Group (ECOG) performance status (φ=0.015, P=0.914). In the multivariate Cox proportional hazards model, only tumor necrosis status at CT was an independent predictive factor of progression-free survival (P=0.003) and overall survival (P=0.004). CONCLUSION: The findings of this study indicate the prognostic potential of tumor necrosis at CT in newly diagnosed DLBCL.
Authors: X U Kahle; F M Montes de Jesus; T C Kwee; T van Meerten; A Diepstra; S Rosati; A W J M Glaudemans; W Noordzij; W J Plattel; M Nijland Journal: Sci Rep Date: 2019-07-30 Impact factor: 4.379
Authors: Xaver U Kahle; Menno Hovingh; Walter Noordzij; Annika Seitz; Arjan Diepstra; Lydia Visser; Anke van den Berg; Tom van Meerten; Gerwin Huls; Ronald Boellaard; Thomas C Kwee; Marcel Nijland Journal: Eur Radiol Date: 2019-04-26 Impact factor: 5.315