Premium
Predictive and discriminating three‐risk‐group prognostic scoring system for staging Hodgkin lymphomas
Author(s) -
MaucortBoulch Delphine,
Djeridane Malika,
Roy Pascal,
Riche Benjamin,
Colonna Pierre,
Andrieu JeanMarie
Publication year - 2007
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.22394
Subject(s) - medicine , lymphoma , stage (stratigraphy) , scoring system , prognostic variable , disease , overall survival , gastroenterology , oncology , paleontology , biology
BACKGROUND. Several 3‐stage Ann Arbor classification‐derived prognostic systems were constructed since 1980 to identify the prognosis of Hodgkin lymphoma (HL). Modern statistical tools were applied to 955 patients treated between 1981 and 1996 to build a 3‐stage prognostic scoring system (PSS). METHODS. Each variable associated with 10‐year overall survival (10‐year OS) was assigned to 2 (0 or 1) or 3 (0, 1 or 3) values. By summing the values attributed to each variable, 3 stages were defined. 10‐year OS, 5‐year event‐free survival (5‐year EFS), and freedom from progression (5‐year FFP) rates of the PSS and of other existing systems were then compared. RESULTS. Four variables were associated with 10‐year OS: age (<40 = 0, ≥40 = 1), number of involved lymphoid areas (1–2 = 0, 3–4 = 1, ≥5 = 2), visceral disease (no = 0, yes = 1), and systemic symptoms (no = 0, yes = 1). Scores 0 and 1, 2 and 3, and ≥4 were attributed to 59.7%, 30.9%, and 9.4% of the patients who had 10‐year OS rates of 93.5, 75.7, and 53.4% and 5‐year EFS / 5‐year FFP rates of 91.2%/90.3%, 78.1%/76.3%, and 54.1%/52.6%, respectively. The discrimination and prediction abilities of the PSS were better than those of the other systems tested; moreover, the PSS adequately identified the few patients with a worse prognosis without resorting to the International Prognostic Score for advanced stages. The PSS was also highly predictive for 489 patients treated between 1997 and 2002. CONCLUSION. PSS is a useful alternative to the existing prognostic systems for evaluating HL patients. Cancer 2007. © 2006 American Cancer Society.