Nomograms for predicting the overall and cancer-specific survival of patients with classical Hodgkin lymphoma: a SEER-based study

Abstract

The aim of this study was to establish nomograms, based on significant clinicopathologic parameters, for predicting the overall survival (OS) and the cancer-specific survival (CSS) of patients with classical Hodgkin lymphoma (CHL). The data of 43,330 CHL patients, diagnosed between 1983 and 2014, were obtainedfrom the database of the Surveillance, Epidemiology, and End Results (SEER) program. These patients were randomly divided into training (n = 30,339) and validation (n = 12,991) cohorts. The Kaplan-Meier method and Cox proportional hazards regression model were used to evaluate the prognostic effects of multiple clinicopathologic parameters on survival. Significant prognostic factors were combined to build nomograms. The predictive performance of nomograms was evaluated using the index of concordance (C-index) and calibration curves. In the training cohort, on univariate and multivariate analyses, age at diagnosis, gender, race, Ann Arbor stage, and histological type significantly correlated with the survival outcomes. These characteristics were used to establish nomograms. The nomograms showed good accuracy in predicting 1-, 5-, and 10-year OS and CSS, with a C-index of 0.794 (95% confidence interval [CI], 0.789-0.799) for OS and 0.760 (95% CI, 0.753-0.767) for CSS. In the validation cohort, the C-index for nomogram-based predictions was 0.787 (95% CI, 0.779-0.795) for OS and 0.769 (95% CI, 0.758-0.780) for CSS. All calibration curves revealed excellent consistency between predicted and actual survival. In summary, novel nomograms were established and validated to predict OS and CSS for patients with CHL. These new prognostic models could aid in improved prediction of survival outcomes leading to reasonable treatment recommendations.

Hodgkin Lymphoma Management; A 20-year Retrospective Study

“…In the present study, the mean age of the patients was about 10 years. Epidemiological studies show that HL is less common in children under 5 years of age so that in developing countries it is about 5%, which is consistent with our study (33)(34)(35). In our study, 19 of the patients (54.3%) were male patients, and in general, the prevalence of HL was higher among boys, and at an early age it was reported as high as 3:1, but with increasing age and in adolescents its rate gets equal in both sexes.…”

Improving survival of 3760 patients with lymphoma: Experience of an academic center over two decades

“…A study 14 from the British National Lymphoma Investigation involving 6834 HL patients demonstrated that the 5‐ and 10‐year OS increased from 73.5% and 62.4% in the 1970s to 93.8% and 89.6% in the 2000s, with a reduced risk of second malignancy and cardiac‐related deaths over time. A study 15 based on the database of Surveillance, Epidemiology, and End Results (SEER) analyzed 43 330 cHL patients between 1983 and 2014 and found that the 5‐ and 10‐year OS rates were 79.8% and 72.3%, respectively. Similarly, the 5‐year OS of patients with cHL increased by 24% during the past two decades in the present study, which confirmed the benefits for HL from advances in modern treatment techniques.…”

Establishment and Verification of Prognostic Nomograms for Patients with Gastrointestinal Stromal Tumors: A SEER-Based Study

“…The nomogram, a graphical display of a mathematical model, combines biological and clinical variables for the identification of the probability of clinical events. Compared with the existing tumor staging system, nomograms achieve more excellent prediction precision and prognostic value [21–23]. Based on the size of tumor, location, and mitotic index of 127 patients, from 1983 to 2002, the Memorial Sloan Kettering Cancer Center (MSKCC) developed a prognostic nomogram that predicted the risk for tumor recurrence after surgical resection of a localized primary GIST.…”