Juya Cui, Tao Wang, Junyan Zhang, Meiru Guo, Jun Zhu, Shuling Hou
{"title":"弥漫性大b细胞淋巴瘤预后图的建立和验证：来自中国北方的一项多中心队列研究。","authors":"Juya Cui, Tao Wang, Junyan Zhang, Meiru Guo, Jun Zhu, Shuling Hou","doi":"10.1007/s12094-025-03955-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to refine the prognostic stratification provided by the International Prognostic Index (IPI) for patients diagnosed with diffuse large B-cell lymphoma (DLBCL) in a northern Chinese cohort and to construct a more precise prognostic nomogram to facilitate individualized treatment strategies and improve survival outcomes.</p><p><strong>Methods: </strong>Clinical data from 1,364 patients diagnosed with DLBCL between January 2000 and December 2019 were retrospectively analyzed across multiple centers in Beijing and Shanxi, China. A prognostic nomogram model for overall survival (OS) was developed incorporating the following variables: age, disease stage, Eastern Cooperative Oncology Group (ECOG) performance status, lactate dehydrogenase (LDH) levels, involvement of various extranodal sites, and disease progression within 6 months (POD6). Model performance was evaluated through receiver-operating characteristic (ROC) curve analysis, calibration curves, concordance index (C-index), and area under the curve (AUC) metrics.</p><p><strong>Results: </strong>The developed nomogram demonstrated consistent predictive capacity, with AUC values exceeding 0.7 at 1-, 3-, and 5-year time points. Calibration plots indicated close alignment with the ideal reference line, with slopes approximating 1, supporting the model's predictive accuracy and clinical relevance. POD6 was identified as the most significant high-risk factor associated with decreased OS (hazard ratio [HR] = 5.13, 95% confidence interval [CI]: 1.03-2.51, p < 0.0001). Among the IPI components, all except ECOG performance status and extranodal involvement remained significant. Notably, central nervous system involvement exhibited the strongest adverse prognostic effect among extranodal sites (HR = 1.61, 95% CI: 1.03-2.51, p = 0.035).</p><p><strong>Conclusion: </strong>A novel prognostic nomogram was established for patients with DLBCL, offering improved prognostic accuracy compared to the traditional IPI. This model presents clinical utility in supporting personalized management and treatment planning.</p><p><strong>Clinical registration number: </strong>Not applicable.</p>","PeriodicalId":50685,"journal":{"name":"Clinical & Translational Oncology","volume":" ","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Development and validation of a prognostic nomogram for diffuse large B-cell lymphoma: a multicenter cohort study from Northern China.\",\"authors\":\"Juya Cui, Tao Wang, Junyan Zhang, Meiru Guo, Jun Zhu, Shuling Hou\",\"doi\":\"10.1007/s12094-025-03955-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aimed to refine the prognostic stratification provided by the International Prognostic Index (IPI) for patients diagnosed with diffuse large B-cell lymphoma (DLBCL) in a northern Chinese cohort and to construct a more precise prognostic nomogram to facilitate individualized treatment strategies and improve survival outcomes.</p><p><strong>Methods: </strong>Clinical data from 1,364 patients diagnosed with DLBCL between January 2000 and December 2019 were retrospectively analyzed across multiple centers in Beijing and Shanxi, China. A prognostic nomogram model for overall survival (OS) was developed incorporating the following variables: age, disease stage, Eastern Cooperative Oncology Group (ECOG) performance status, lactate dehydrogenase (LDH) levels, involvement of various extranodal sites, and disease progression within 6 months (POD6). Model performance was evaluated through receiver-operating characteristic (ROC) curve analysis, calibration curves, concordance index (C-index), and area under the curve (AUC) metrics.</p><p><strong>Results: </strong>The developed nomogram demonstrated consistent predictive capacity, with AUC values exceeding 0.7 at 1-, 3-, and 5-year time points. Calibration plots indicated close alignment with the ideal reference line, with slopes approximating 1, supporting the model's predictive accuracy and clinical relevance. POD6 was identified as the most significant high-risk factor associated with decreased OS (hazard ratio [HR] = 5.13, 95% confidence interval [CI]: 1.03-2.51, p < 0.0001). Among the IPI components, all except ECOG performance status and extranodal involvement remained significant. Notably, central nervous system involvement exhibited the strongest adverse prognostic effect among extranodal sites (HR = 1.61, 95% CI: 1.03-2.51, p = 0.035).</p><p><strong>Conclusion: </strong>A novel prognostic nomogram was established for patients with DLBCL, offering improved prognostic accuracy compared to the traditional IPI. This model presents clinical utility in supporting personalized management and treatment planning.</p><p><strong>Clinical registration number: </strong>Not applicable.</p>\",\"PeriodicalId\":50685,\"journal\":{\"name\":\"Clinical & Translational Oncology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-05-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical & Translational Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s12094-025-03955-5\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical & Translational Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12094-025-03955-5","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
Development and validation of a prognostic nomogram for diffuse large B-cell lymphoma: a multicenter cohort study from Northern China.
Objective: This study aimed to refine the prognostic stratification provided by the International Prognostic Index (IPI) for patients diagnosed with diffuse large B-cell lymphoma (DLBCL) in a northern Chinese cohort and to construct a more precise prognostic nomogram to facilitate individualized treatment strategies and improve survival outcomes.
Methods: Clinical data from 1,364 patients diagnosed with DLBCL between January 2000 and December 2019 were retrospectively analyzed across multiple centers in Beijing and Shanxi, China. A prognostic nomogram model for overall survival (OS) was developed incorporating the following variables: age, disease stage, Eastern Cooperative Oncology Group (ECOG) performance status, lactate dehydrogenase (LDH) levels, involvement of various extranodal sites, and disease progression within 6 months (POD6). Model performance was evaluated through receiver-operating characteristic (ROC) curve analysis, calibration curves, concordance index (C-index), and area under the curve (AUC) metrics.
Results: The developed nomogram demonstrated consistent predictive capacity, with AUC values exceeding 0.7 at 1-, 3-, and 5-year time points. Calibration plots indicated close alignment with the ideal reference line, with slopes approximating 1, supporting the model's predictive accuracy and clinical relevance. POD6 was identified as the most significant high-risk factor associated with decreased OS (hazard ratio [HR] = 5.13, 95% confidence interval [CI]: 1.03-2.51, p < 0.0001). Among the IPI components, all except ECOG performance status and extranodal involvement remained significant. Notably, central nervous system involvement exhibited the strongest adverse prognostic effect among extranodal sites (HR = 1.61, 95% CI: 1.03-2.51, p = 0.035).
Conclusion: A novel prognostic nomogram was established for patients with DLBCL, offering improved prognostic accuracy compared to the traditional IPI. This model presents clinical utility in supporting personalized management and treatment planning.
期刊介绍：
Clinical and Translational Oncology is an international journal devoted to fostering interaction between experimental and clinical oncology. It covers all aspects of research on cancer, from the more basic discoveries dealing with both cell and molecular biology of tumour cells, to the most advanced clinical assays of conventional and new drugs. In addition, the journal has a strong commitment to facilitating the transfer of knowledge from the basic laboratory to the clinical practice, with the publication of educational series devoted to closing the gap between molecular and clinical oncologists. Molecular biology of tumours, identification of new targets for cancer therapy, and new technologies for research and treatment of cancer are the major themes covered by the educational series. Full research articles on a broad spectrum of subjects, including the molecular and cellular bases of disease, aetiology, pathophysiology, pathology, epidemiology, clinical features, and the diagnosis, prognosis and treatment of cancer, will be considered for publication.
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