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

TY - JOUR

T1 - Simplicity at the cost of predictive accuracy in diffuse large B-cell lymphoma

T2 - a critical assessment of the R-IPI, IPI, and NCCN-IPI

AU - Biccler, Jorne

AU - Eloranta, Sandra

AU - de Nully Brown, Peter

AU - Frederiksen, Henrik

AU - Jerkeman, Mats

AU - Smedby, Karin E.

AU - Bøgsted, Martin

AU - El-Galaly, Tarec C.

PY - 2018/1

Y1 - 2018/1

N2 - 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.

AB - 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.

KW - Diffuse large B-cell lymphoma

KW - IPI

KW - prognosis

KW - prognostic factors

KW - risk modeling

U2 - 10.1002/cam4.1271

DO - 10.1002/cam4.1271

M3 - Journal article

C2 - 29239133

AN - SCOPUS:85038019372

SN - 2045-7634

VL - 7

SP - 114

EP - 122

JO - Cancer Medicine

JF - Cancer Medicine

IS - 1

ER -