Risk Prediction for Early Mortality in Patients with Newly Diagnosed Primary CNS Lymphoma

Lin, Chia Hsin; Yang, Ching Fen; Yang, Huai Che; Fay, Li Yu; Yeh, Chiu Mei; Kuan, Ai Seon; Wang, Hao‐Yuan; Gau, Jyh Pyng; Hsiao, Liang Tsai; Chiou, Tzeon Jye; Chen, Po Min; Liu, Yao Chung; Ko, Po Shen; Liu, Jin Hwang; Liu, Chia Jen

doi:10.7150/jca.32467

Cited by 7 publications

(9 citation statements)

References 42 publications

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“…ECOG of 2 was used as cutoff according to prior studies of PCNSL . Similarly, age of 80 years was chosen as cutoff according to previous research showing 80 years as a potential risk factor for mortality in patients with systemic diffuse large B‐cell lymphoma as well as PCNSL . Cutoff values of hemoglobin, C‐reactive protein, and bilirubin levels were 11.85 g/dL, 2.94 mg/dL, and 0.52 mg/dL, respectively, which were correlated with clinical outcomes in one previous study of diffuse large B‐cell lymphoma .…”

Section: Methodsmentioning

confidence: 99%

A new prognostic score for disease progression and mortality in patients with newly diagnosed primary CNS lymphoma

et al. 2020

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Background Although various prognostic models for primary central nervous system lymphoma (PCNSL) have been developed, there is no consensus regarding the optimal prognostic index. We aimed to evaluate potential prognostic factors and construct a novel predictive model for PCNSL patients. Methods We enrolled newly diagnosed PCNSL patients between 2003 and 2015. The primary endpoint was progression‐free survival (PFS), and the secondary endpoint was overall survival (OS). The prognostic factors identified using multivariate Cox proportional hazards models were used to develop a predictive model. We subsequently validated the prognostic model in an independent cohort. We also evaluated the validity of the existing scores: the International Extranodal Lymphoma Study Group (IELSG), the Nottingham/Barcelona (NB), and the Memorial Sloan‐Kettering Cancer Center models (MSKCC). Results We identified 101 patients with newly diagnosed PCNSL at our center. Multivariate analysis showed that age ≥80, deep brain lesions, and ECOG ≥2 were independent risk factors of PFS. Assigning one point for each factor, we constructed a novel prognostic model, the Taipei Score, with four distinct risk groups (0‐3 points). The performances of the Taipei Score in discriminating both PFS and OS in the training cohort were significant, and the score was validated in the external validation cohort. The IELSG, NB and MSKCC models had insufficient discriminative ability for either PFS or OS in both cohorts. Conclusion The Taipei Score is a simple model that discriminates PFS and OS for PCNSL patients. The score may offer disease risk stratification and facilitate clinical decision‐making.

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Section: Methodsmentioning

confidence: 99%

A new prognostic score for disease progression and mortality in patients with newly diagnosed primary CNS lymphoma

et al. 2020

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“…Lin et al reported that age ≥ 80 years and involvement of the basal ganglia were identified as independent risk factors of early mortality. 41 On the other hand, the study conducted in Brazil revealed that older age, male gender and white race were associated with higher mortality in lymphoma patients. 42 Therefore, effective interventional strategies should be implemented among comorbid and advanced-stage patients to reduce mortality and extend survival time among all the selected malignancies in the study setting.…”

Section: Discussionmentioning

confidence: 99%

Treatment Outcomes and Its Associated Factors Among Adult Patients with Selected Solid Malignancies at Kenyatta National Hospital: A Hospital-Based Prospective Cohort Study

Degu¹,

Terefe²,

Some³

et al. 2022

CMAR

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Introduction The treatment outcome of cancer is poor in the African setting due to inadequate treatment and diagnostic facilities. However, there is a paucity of data on solid cancers in Kenya. Hence, this study aimed to investigate the treatment outcomes and its determinant factors among adult patients diagnosed with selected solid malignancies at Kenyatta National Hospital (KNH). Materials and Methods A prospective cohort study was employed at the Oncology Department of KNH from 1 st July 2020 to 31 st December 2021. All new patients with a confirmed diagnosis of lymphoma, prostate cancer and breast cancer were studied. A consecutive sample of 99 breast cancer, 50 lymphomas, and 82 prostate cancer patients was included in the study. Semi-structured questionnaires consisting of socio-demographics, clinical characteristics, and quality of life were employed to collect the data. All enrolled patients were followed prospectively for 12 months. Treatment outcomes were reported as mortality, cancer-specific survival and health-related quality of life. The data were entered and analyzed using the SPSS 20.0 statistical software. Survival outcomes and its predictors were evaluated using the Kaplan–Meier analysis and Cox regression analyses, respectively. Results The study showed that the mortality rate among breast and prostate cancer patients was 3% and 4.9%, respectively. In contrast, the mortality rate was 10% among lymphoma patients. Most of the patients had partial remission and a good overall global health-related quality of life. Older age above 60 years, co-morbidity, distant metastasis and advanced stages of disease were significant predictors of mortality. Conclusion Although the mortality was not high at 12 months, only a few patients had complete remission. For many patients, the disease was progressing, despite 12-month mortality was not high. Therefore, longer follow-up will be required to report cancer mortality accurately. In addition, most of the patients had a good overall global health-related quality of life.

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“…In contrast, previous studies found that older age and pretreatment PS are significant prognostic factors. [ 2 3 5 6 10 11 13 14 ] Most previous studies defined older age as >60 years,[ 3 6 13 16 17 18 ] whereas others used >50 years as the cut off. [ 2 5 11 14 ] In our study, older age was a significant predictor of poor outcomes in the univariable analysis, and age was a poor prognostic factor, but not significant, in the multivariable analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, this study found that patients had a short survival time with a median overall survival of 7 months compared with previous studies that found that the median overall survival of PCNSL patients was higher and ranged from 9 to 100 months. [3,5,7,10,12,[14][15][16] Based on our knowledge, the different survival rates were primarily influenced by the patient's status and treatment options. A patient's preoperative status plays a significant role in determining treatment outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…[7] Patient prognosis depends on various patient factors, PCNSL factors itself, and whether or not a patient has received treatment. [9,10] The prognostic models for predicting patient outcomes, such as the International Extranodal Lymphoma Study Group score, [6] Memorial Sloan Kettering Cancer Center score, [5] and the Nottingham-Barcelona score, [11] are well established.…”

Section: Introductionmentioning

confidence: 99%

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Outcome and prognostic factors of primary central nervous system lymphoma in Southern Thailand

2020

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Context: Primary central nervous system lymphoma (PCNSL) is an uncommon type of brain tumor that has an aggressive disease course. Its outcomes, including factor-related outcomes, are therefore not well established in our country. Aims: This study aims to investigate the outcome and prognostic factors in PCNSL patients at our institute. Settings and Design: Retrospective study in a single university hospital. Subjects and Methods: We reviewed consecutive cases of newly diagnosed PCNSL at Prince of Songkla University from 2005 to 2018. The data were collected to evaluate the treatment outcomes and prognostic factors. Statistical Analysis Used: The Kaplan–Meier method for survival analysis, and Cox regression for variable analysis. Results: Eighty-seven patients met the inclusion criteria. Patients were predominantly male, and their mean age was 58.8 ± 11.2 years. Only four patients were infected with HIV. Motor weakness was the most common presentation, and neuroimaging revealed multiple lesions in 56.3% of patients. The patients were divided into four groups according to treatment modality: palliative treatment, whole-brain radiotherapy (WBRT) alone, chemotherapy (CMT) alone, and combined WBRT and CMT groups. The median overall survival was 7 months. The 1-, 2-, and 5-year survival rates were 29%, 21.5%, and 4.6%, respectively. The age of >60 years was a significant poor prognostic factor. In addition, patients who received combined treatment exhibited the highest survival rate. Conclusions: PCNSL has a low survival rate, even in the present era. Older age is the most substantial factor associated with unfavorable outcomes. The most effective treatment is combined with WBRT and CMT.

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Risk Prediction for Early Mortality in Patients with Newly Diagnosed Primary CNS Lymphoma

Cited by 7 publications

References 42 publications

A new prognostic score for disease progression and mortality in patients with newly diagnosed primary CNS lymphoma

A new prognostic score for disease progression and mortality in patients with newly diagnosed primary CNS lymphoma

Treatment Outcomes and Its Associated Factors Among Adult Patients with Selected Solid Malignancies at Kenyatta National Hospital: A Hospital-Based Prospective Cohort Study

Outcome and prognostic factors of primary central nervous system lymphoma in Southern Thailand

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