Predictive and discriminating three-risk-group prognostic scoring system for staging Hodgkin lymphomas.
BACKGROUND
Several 3-stage Ann Arbor classification-derived prognostic systems were constructed since 1980 to identify the prognosis of Hodgkin lymphoma (HL). Modern statistical tools were applied to 955 patients treated between 1981 and 1996 to build a 3-stage prognostic scoring system (PSS).


METHODS
Each variable associated with 10-year overall survival (10-year OS) was assigned to 2 (0 or 1) or 3 (0, 1 or 3) values. By summing the values attributed to each variable, 3 stages were defined. 10-year OS, 5-year event-free survival (5-year EFS), and freedom from progression (5-year FFP) rates of the PSS and of other existing systems were then compared.


RESULTS
Four variables were associated with 10-year OS: age (<40 = 0, >or=40 = 1), number of involved lymphoid areas (1-2 = 0, 3-4 = 1, >or=5 = 2), visceral disease (no = 0, yes = 1), and systemic symptoms (no = 0, yes = 1). Scores 0 and 1, 2 and 3, and >or=4 were attributed to 59.7%, 30.9%, and 9.4% of the patients who had 10-year OS rates of 93.5, 75.7, and 53.4% and 5-year EFS / 5-year FFP rates of 91.2%/90.3%, 78.1%/76.3%, and 54.1%/52.6%, respectively. The discrimination and prediction abilities of the PSS were better than those of the other systems tested; moreover, the PSS adequately identified the few patients with a worse prognosis without resorting to the International Prognostic Score for advanced stages. The PSS was also highly predictive for 489 patients treated between 1997 and 2002.


CONCLUSIONS
PSS is a useful alternative to the existing prognostic systems for evaluating HL patients.
Maucort-Boulch
Delphine
D
Service de Biostatistique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon et Laboratoire Biostatistique Sante, equipe UMR CNRS 5558, Lyon, France.
Djeridane
Malika
M
Roy
Pascal
P
Riche
Benjamin
B
Colonna
Pierre
P
Andrieu
Jean-Marie
JM
D000328:Adult; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000145:classification / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D036102:Peripheral Blood Stem Cell Transplantation; D011379:Prognosis; D011878:Radiotherapy / Q000379:methods; D015203:Reproducibility of Results; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors