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Validation of nomogram-revised risk index and comparison with other models for extranodal nasal-type NK/T-cell lymphoma in the modern chemotherapy era: indication for prognostication and clinical decision-making
Leukemia ( IF 11.4 ) Pub Date : 2020-03-09 , DOI: 10.1038/s41375-020-0791-3
Si-Ye Chen , Yong Yang , Shu-Nan Qi , Ying Wang , Chen Hu , Xia He , Li-Ling Zhang , Gang Wu , Bao-Lin Qu , Li-Ting Qian , Xiao-Rong Hou , Fu-Quan Zhang , Xue-Ying Qiao , Hua Wang , Gao-Feng Li , Yu-Jing Zhang , Yuan Zhu , Jian-Zhong Cao , Sheng-Min Lan , Jun-Xin Wu , Tao Wu , Su-Yu Zhu , Mei Shi , Li-Ming Xu , Zhi-Yong Yuan , Joachim Yahalom , Richard Tsang , Yu-Qin Song , Jun Zhu , Hang Su , Ye-Xiong Li

Derived from our original nomogram study by using the risk variables from multivariable analyses in the derivation cohort of 1383 patients with extranodal NK/T-cell lymphoma, nasal-type (ENKTCL) who were mostly treated with anthracycline-based chemotherapy, we propose an easily used nomogram-revised risk index (NRI), validated it and compared with Ann Arbor staging, the International Prognostic Index (IPI), Korean Prognostic Index (KPI), and prognostic index of natural killer lymphoma (PINK) for overall survival (OS) prediction by examining calibration, discrimination, and decision curve analysis in a validation cohort of 1582 patients primarily treated with non-anthracycline-based chemotherapy. The calibration of the NRI showed satisfactory for predicting 3- and 5-year OS in the validation cohort. The Harrell’s C-index and integrated Brier score (IBS) of the NRI for OS prediction demonstrated a better performance than that of the Ann Arbor staging system, IPI, KPI, and PINK. Decision curve analysis of the NRI also showed a superior outcome. The NRI is a promising tool for stratifying patients with ENKTCL into risk groups for designing clinical trials and for selecting appropriate individualized treatment.



中文翻译:

诺模图修订的风险指数的验证以及与现代化疗时代结外鼻型NK / T细胞淋巴瘤的其他模型的比较:预后和临床决策的指征

通过对1383例结节性NK / T细胞淋巴瘤,鼻腔型(ENKTCL)患者(主要接受基于蒽环类药物治疗的患者)的派生队列中的多变量分析中的风险变量,从我们最初的列线图研究中得出,我们建议采用一种简便易行的方法使用诺法图修订的风险指数(NRI)进行验证,并与Ann Arbor分期,国际预后指数(IPI),韩国预后指数(KPI)和自然杀伤性淋巴瘤(PINK)的总生存期(OS)进行比较通过在以非蒽环类为主的化学疗法治疗的1582名患者的验证队列中检查校正,歧视和决策曲线分析来进行预测。NRI的校准对验证队列中的3年和5年OS预测显示令人满意。NRI用于操作系统预测的Harrell的C指数和综合Brier得分(IBS)表现出比Ann Arbor分期系统,IPI,KPI和PINK更好的性能。NRI的决策曲线分析也显示了更好的结果。NRI是将ENKTCL患者分为风险组以设计临床试验和选择合适的个体化治疗的有前途的工具。

更新日期:2020-04-24
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