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Simplicity at the cost of predictive accuracy in diffuse large B-cell lymphoma : A critical assessment of the R-IPI, IPI, and NCCN-IPI

Biccler, Jorne; Eloranta, Sandra; de Nully Brown, Peter; Frederiksen, Henrik; Jerkeman, Mats LU ; Smedby, Karin E.; Bøgsted, Martin and El-Galaly, Tarec C. (2017) In Cancer Medicine
Abstract

The international prognostic index (IPI) and similar models form the cornerstone of clinical assessment in newly diagnosed diffuse large B-cell lymphoma (DLBCL). While being simple and convenient to use, their inadequate use of the available clinical data is a major weakness. In this study, we compared performance of the International Prognostic Index (IPI) and its variations (R-IPI and NCCN-IPI) to a Cox proportional hazards (CPH) model using the same covariates in nondichotomized form. All models were tested in 4863 newly diagnosed DLBCL patients from population-based Nordic registers. The CPH model led to a substantial increase in predictive accuracy as compared to conventional prognostic scores when evaluated by the area under the... (More)

The international prognostic index (IPI) and similar models form the cornerstone of clinical assessment in newly diagnosed diffuse large B-cell lymphoma (DLBCL). While being simple and convenient to use, their inadequate use of the available clinical data is a major weakness. In this study, we compared performance of the International Prognostic Index (IPI) and its variations (R-IPI and NCCN-IPI) to a Cox proportional hazards (CPH) model using the same covariates in nondichotomized form. All models were tested in 4863 newly diagnosed DLBCL patients from population-based Nordic registers. The CPH model led to a substantial increase in predictive accuracy as compared to conventional prognostic scores when evaluated by the area under the curve and other relevant tests. Furthermore, the generation of patient-specific survival curves rather than assigning patients to one of few predefined risk groups is a relevant step toward personalized management and treatment. A test-version is available on lymphomapredictor.org.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
IPI, Diffuse large B-cell lymphoma, Prognosis, Prognostic factors, Risk modeling
in
Cancer Medicine
publisher
Wiley-Blackwell
external identifiers
  • scopus:85038019372
ISSN
2045-7634
DOI
10.1002/cam4.1271
language
English
LU publication?
yes
id
d3da6785-adb6-4854-97ca-34b69f528bd3
date added to LUP
2018-01-10 12:29:56
date last changed
2018-01-11 03:00:08
@article{d3da6785-adb6-4854-97ca-34b69f528bd3,
  abstract     = {<p>The international prognostic index (IPI) and similar models form the cornerstone of clinical assessment in newly diagnosed diffuse large B-cell lymphoma (DLBCL). While being simple and convenient to use, their inadequate use of the available clinical data is a major weakness. In this study, we compared performance of the International Prognostic Index (IPI) and its variations (R-IPI and NCCN-IPI) to a Cox proportional hazards (CPH) model using the same covariates in nondichotomized form. All models were tested in 4863 newly diagnosed DLBCL patients from population-based Nordic registers. The CPH model led to a substantial increase in predictive accuracy as compared to conventional prognostic scores when evaluated by the area under the curve and other relevant tests. Furthermore, the generation of patient-specific survival curves rather than assigning patients to one of few predefined risk groups is a relevant step toward personalized management and treatment. A test-version is available on lymphomapredictor.org.</p>},
  author       = {Biccler, Jorne and Eloranta, Sandra and de Nully Brown, Peter and Frederiksen, Henrik and Jerkeman, Mats and Smedby, Karin E. and Bøgsted, Martin and El-Galaly, Tarec C.},
  issn         = {2045-7634},
  keyword      = {IPI,Diffuse large B-cell lymphoma,Prognosis,Prognostic factors,Risk modeling},
  language     = {eng},
  publisher    = {Wiley-Blackwell},
  series       = {Cancer Medicine},
  title        = {Simplicity at the cost of predictive accuracy in diffuse large B-cell lymphoma : A critical assessment of the R-IPI, IPI, and NCCN-IPI},
  url          = {http://dx.doi.org/10.1002/cam4.1271},
  year         = {2017},
}