Ho-Young Yhim1,2, Yong Park3, Yeon-Hee Han4, Sungeun Kim5, Sae-Ryung Kang6, Joon-Ho Moon7, Ju Hye Jeong8, Ho-Jin Shin9, Keunyoung Kim10, Yoon Seok Choi11, Kunho Kim12, Min Kyoung Kim13, Eunjung Kong14, Dae Sik Kim15, Jae Seon Eo16, Ji Hyun Lee17, Do-Young Kang18, Won Sik Lee19, Seok Mo Lee20, Young Rok Do21, Jun Soo Ham22, Seok Jin Kim22, Won Seog Kim22, Joon Young Choi23, Deok-Hwan Yang24, Jae-Yong Kwak1,2. 1. Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, South Korea. 2. Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea. 3. Department of Internal Medicine, Korea University Anam Hospital College of Medicine, Seoul, South Korea. 4. Department of Nuclear Medicine, Chonbuk National University Hospital, Jeonju, South Korea. 5. Department of Nuclear Medicine, Korea University Anam Hospital, Seoul, South Korea. 6. Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Jeollanam-do, South Korea. 7. Department of Internal Medicine, Kyungpook National University Hospital, Daegu, South Korea. 8. Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, South Korea. 9. Department of Internal Medicine, Pusan National University Hospital, Busan, South Korea. 10. Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea. 11. Department of Internal Medicine, Chungnam National University Hospital, Daejeon, South Korea. 12. Department of Nuclear Medicine, Chungnam National University Hospital, Daejeon, South Korea. 13. Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, South Korea. 14. Department of Nuclear Medicine, Yeungnam University College of Medicine, Daegu, South Korea. 15. Department of Internal Medicine, Korea University Guro Hospital College of Medicine, Seoul, South Korea. 16. Department of Nuclear Medicine, Korea University Guro Hospital College of Medicine, Seoul, South Korea. 17. Department of Internal Medicine, Dong-A University College of Medicine, Busan, South Korea. 18. Department of Nuclear Medicine, Dong-A University College of Medicine, Busan, South Korea. 19. Department of Internal Medicine, Inje University College of Medicine, Inje University Busan Paik Hospital, Busan, South Korea. 20. Department of Nuclear Medicine, Inje University College of Medicine, Inje University Busan Paik Hospital, Busan, South Korea. 21. Department of Internal Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea. 22. Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea. 23. Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. 24. Department of Internal Medicine, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun, Jeollanam-do, 519-763, Republic of Korea. drydh1685@hotmail.com.
Abstract
PURPOSE: The aim of this study was to establish a risk-stratification model integrating posttreatment metabolic response using the Deauville score and the pretreatment National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI) in nodal PTCLs. METHODS: We retrospectively analysed 326 patients with newly diagnosed nodal PTCLs between January 2005 and June 2016 and both baseline and posttreatment PET/CT data. The final model was validated using an independent prospective cohort of 79 patients. RESULTS: Posttreatment Deauville score (1/2, 3, and 4/5) and the NCCN-IPI (low, low-intermediate, high-intermediate, and high) were independently associated with progression-free survival: for the Deauville score, the hazard ratios (HRs) were 1.00 vs. 2.16 (95% CI 1.47-3.18) vs. 7.86 (5.66-10.92), P < 0.001; and for the NCCN-IPI, the HRs were 1.00 vs. 2.31 (95% CI 1.20-4.41) vs. 4.42 (2.36-8.26) vs. 7.09 (3.57-14.06), P < 0.001. Based on these results, we developed a simplified three-group risk model comprising a low-risk group (low or low-intermediate NCCN-IPI with a posttreatment Deauville score of 1 or 2, or low NCCN-IPI with a Deauville score of 3), a high-risk group (high or high-intermediate NCCN-IPI with a Deauville score of 1/2 or 3, or low-intermediate NCCN-IPI with a Deauville score of 3), and a treatment failure group (Deauville score 4 or 5). This model was significantly associated with progression-free survival (5-year, 70.3%, 31.4%, and 4.7%; P < 0.001) and overall survival (5-year, 82.1%, 45.5%, and 14.7%; P < 0.001). Similar associations were also observed in the independent validation cohort. CONCLUSION: The risk-stratification model integrating posttreatment Deauville score and pretreatment NCCN-IPI is a powerful tool for predicting treatment failure in patients with nodal PTCLs.
PURPOSE: The aim of this study was to establish a risk-stratification model integrating posttreatment metabolic response using the Deauville score and the pretreatment National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI) in nodal PTCLs. METHODS: We retrospectively analysed 326 patients with newly diagnosed nodal PTCLs between January 2005 and June 2016 and both baseline and posttreatment PET/CT data. The final model was validated using an independent prospective cohort of 79 patients. RESULTS: Posttreatment Deauville score (1/2, 3, and 4/5) and the NCCN-IPI (low, low-intermediate, high-intermediate, and high) were independently associated with progression-free survival: for the Deauville score, the hazard ratios (HRs) were 1.00 vs. 2.16 (95% CI 1.47-3.18) vs. 7.86 (5.66-10.92), P < 0.001; and for the NCCN-IPI, the HRs were 1.00 vs. 2.31 (95% CI 1.20-4.41) vs. 4.42 (2.36-8.26) vs. 7.09 (3.57-14.06), P < 0.001. Based on these results, we developed a simplified three-group risk model comprising a low-risk group (low or low-intermediate NCCN-IPI with a posttreatment Deauville score of 1 or 2, or low NCCN-IPI with a Deauville score of 3), a high-risk group (high or high-intermediate NCCN-IPI with a Deauville score of 1/2 or 3, or low-intermediate NCCN-IPI with a Deauville score of 3), and a treatment failure group (Deauville score 4 or 5). This model was significantly associated with progression-free survival (5-year, 70.3%, 31.4%, and 4.7%; P < 0.001) and overall survival (5-year, 82.1%, 45.5%, and 14.7%; P < 0.001). Similar associations were also observed in the independent validation cohort. CONCLUSION: The risk-stratification model integrating posttreatment Deauville score and pretreatment NCCN-IPI is a powerful tool for predicting treatment failure in patients with nodal PTCLs.
Entities:
Keywords:
International prognostic index; PET/CT; Peripheral T-cell lymphoma; Prognosis; Treatment
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