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Liang X, Zhang M, Zhang Z, Tan S, Li Y, Zhong Y, Shao Y, Kong Y, Yang Y, Li S, Xu J, Li Z, Zhu X. Nomogram model and risk score predicting overall survival and guiding clinical decision in patients with Hodgkin's lymphoma: an observational study using SEER population-based data. BMJ Open 2022; 12:e055524. [PMID: 35672070 PMCID: PMC9174788 DOI: 10.1136/bmjopen-2021-055524] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION This study developed a prognostic nomogram of Hodgkin lymphoma (HL) for purpose of discussing independent risk factors for HL patients with Surveillance, Epidemiology and End Results (SEER) database. METHODS We collected data of HL patients from 2010 to 2015 from the SEER database and divided it into two cohorts: the training and the verification cohort. Then the univariate and the multivariate Cox regression analyses were conducted in the training, the verification as well as the total cohort, after which the intersection of variables with statistical significance was taken as independent risk factors to establish the nomogram. The predictive ability of the nomogram was validated by the Concordance Index. Additionally, the calibration curve and receiver operating characteristic curve were implemented to evaluate the accuracy and discrimination. Finally, we obtained 1-year, 3-year and 5-year survival rates of HL patients. RESULTS 10 912 patients were eligible for the study. We discovered that Derived American Joint Committee on Cancer (AJCC) Stage Group, lymphoma subtype, radiotherapy and chemotherapy were four independent risk factors affecting the prognosis of HL patients. The 1-year, 3-year and 5-year survival rates for high-risk patients were 85.4%, 79.9% and 76.0%, respectively. It was confirmed that patients with stage I or II had a better prognosis. Radiotherapy and chemotherapy had a positive impact on HL outcomes. However, patients with lymphocyte-depleted HL were of poor prognosis. CONCLUSIONS The nomogram we constructed could better predict the prognosis of patients with HL. Patients with HL had good long-term outcomes but novel therapies are still in need for fewer complications.
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Affiliation(s)
- Xiangping Liang
- School of Laboratory Medicine, Hangzhou Medical College, Hangzhou, People's Republic of China
- Department of Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China
| | - Mingtao Zhang
- Computational Oncology Laboratory, Guangdong Medical University, Zhanjiang, People's Republic of China
| | - Zherui Zhang
- School of Laboratory and Biotechnology, Southern Medical University, Guangzhou, People's Republic of China
| | - Shuzhen Tan
- Department of Dermatology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Yingqi Li
- Computational Oncology Laboratory, Guangdong Medical University, Zhanjiang, People's Republic of China
| | - Yueyuan Zhong
- Computational Oncology Laboratory, Guangdong Medical University, Zhanjiang, People's Republic of China
| | - Yingqi Shao
- Computational Oncology Laboratory, Guangdong Medical University, Zhanjiang, People's Republic of China
| | - Yi Kong
- Computational Oncology Laboratory, Guangdong Medical University, Zhanjiang, People's Republic of China
| | - Yue Yang
- Computational Oncology Laboratory, Guangdong Medical University, Zhanjiang, People's Republic of China
| | - Shang Li
- Computational Oncology Laboratory, Guangdong Medical University, Zhanjiang, People's Republic of China
| | - Jiayi Xu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People's Republic of China
| | - Zesong Li
- Guangdong Provincial Key Laboratory of Systems Biology and Synthetic Biology for Urogenital Tumors, Department of Urology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital (Shenzhen Institute of Translational Medicine), Shenzhen, People's Republic of China
| | - Xiao Zhu
- School of Laboratory Medicine, Hangzhou Medical College, Hangzhou, People's Republic of China
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Wang S, Jia M, Han J, Zhang R, Huang K, Li P, Li Q, Qiao Y, Song Q, Fu Z. Radiotherapy for patients with stage IV classical Hodgkin lymphoma: a propensity-matched analysis of the surveillance, epidemiology, and end results database. Cancer Biol Ther 2020; 21:832-840. [PMID: 32835569 DOI: 10.1080/15384047.2020.1796194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Background The survival advantage of radiotherapy for patients with stage IV classic Hodgkin lymphoma (HL) has not been adequately evaluated. Methods We analyzed patients with stage IV HL enrolled from the Surveillance, Epidemiology, and End Results (SEER) registry from January 2000 to December 2012. Propensity score (PS) analysis with 1:2 matching was performed to ensure well-balanced characteristics of the comparison groups. Kaplan-Meier and Cox proportional hazardous model were used to evaluate the overall survival (OS), cancer-specific survival (CSS), the hazards ratio (HR) and corresponding 95% confidence intervals (95% CI). Results Overall, for all patients with stage IV HL, receiving radiotherapy was associated with both significantly improved OS and CSS. Radiotherapy to any lesions could independently improve the OS and CSS by 30% to 36% in the multivariate analyses before and after PS matching (PSM), with the best improvement of 33% to 40% observed for patients with nodular sclerosis (P < 0.05) among all HL pathological types. In particular, radiotherapy, most likely to the residual site, was more pronouncedly associated with the improvement in survival for patients with stage IV HL who were young (age<45, P < .05) or without B symptoms (PInteraction for OS = 0.099, PInteraction for CSS = 0.255). For those patients without B symptoms, after PSM, the OS was improved by 65% (P = .021). Conclusions The large SEER results support that radiotherapy is associated with better survival of patients with stage IV HL.
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Affiliation(s)
- Shijie Wang
- Cancer Center, Renmin Hospital of Wuhan University , Wuhan, China
| | - Mingfang Jia
- Department of Health Management, Renmin Hospital of Wuhan University , Wuhan, China
| | - Jianglong Han
- Cancer Center, Renmin Hospital of Wuhan University , Wuhan, China
| | - Rui Zhang
- Cancer Center, Renmin Hospital of Wuhan University , Wuhan, China
| | - Kejie Huang
- Cancer Center, Renmin Hospital of Wuhan University , Wuhan, China
| | - Ping Li
- Cancer Center, Renmin Hospital of Wuhan University , Wuhan, China
| | - Qin Li
- Cancer Center, Renmin Hospital of Wuhan University , Wuhan, China
| | - Yunfeng Qiao
- Cancer Center, Renmin Hospital of Wuhan University , Wuhan, China
| | - Qibin Song
- Cancer Center, Renmin Hospital of Wuhan University , Wuhan, China
| | - Zhenming Fu
- Cancer Center, Renmin Hospital of Wuhan University , Wuhan, China
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Khan MK, Jiang C, Subramanian K. Radiotherapy Should Be Part of a Multidisciplinary Discussion for Most Patients With Lymphoma. J Oncol Pract 2019; 15:173-174. [DOI: 10.1200/jop.19.00107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Cecilia Jiang
- Emory University Winship Cancer Institute, Atlanta, GA
| | - Kritika Subramanian
- Emory University Winship Cancer Institute, Atlanta, GA
- KU Leuven-University of Leuven, Leuven, Belgium
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