Abstract
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.
Highlights
Extranodal natural killer/T-cell lymphoma, nasal-type (ENKTCL) is a heterogeneous disease with variable clinical features and prognoses [1,2,3,4,5]
We previously developed and validated a nomogram for predicting survival for individual patients who were mostly treated with anthracycline-based chemotherapy and conventional radiotherapy [19]
The derivation cohort included 1383 ENKTCL patients mostly treated with anthracycline-based chemotherapy [19], whereas the validation cohort included 1582 patients treated with nonanthracycline-based chemotherapy for independent validation and comparison
Summary
Extranodal natural killer/T-cell lymphoma, nasal-type (ENKTCL) is a heterogeneous disease with variable clinical features and prognoses [1,2,3,4,5]. Through refined stratification and more relevant information in clinical decision-making Several models, such as the International Prognostic Index (IPI), Korea Prognostic Index (KPI), and prognostic index of natural killer lymphoma (PINK) have been validated in patients with ENKTCL [15,16,17,18]. Efforts to improve the model’s discrimination have focused on adding new prognostic factors, regrouping the original prognostic index in various cohorts, or focusing on early-stage patients [12, 20, 21] None of these models has undergone comprehensive evaluation to provide further evidence for efficacy and general applicability. We compare the relative accuracy of its predictive performance and usefulness of clinical decision-making with the commonly used models in the modern chemotherapy era
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