title: Validation, revision and extension of the Follicular Lymphoma International Prognostic Index (FLIPI) in a population-based setting.
abstract: BACKGROUND
  The aim of this study was to validate the Follicular Lymphoma International Prognostic Index (FLIPI) in a population-based cohort and to study the relevance of revision and extension of the FLIPI.
  
  
  METHODS
  Data of 353 unselected patients, 1993-2002, in the Eindhoven Cancer Registry, were collected. Follow-up was completed up to 1 January 2006. Multiple imputations for missing covariates were used. Validity was assessed by comparing observed to predicted survival of the original model and of a revised model with other prognostic variables.
  
  
  RESULTS
  The original FLIPI stratified our cohort into three different risk groups based on stage, Hb, lactate dehydrogenase, nodal involvement and age. The discrimination between risk groups was not as good as in the original cohort. A model including age in three categories (< or =60/61-70/>70 years) and presence of cardiovascular disease (CVD) (yes/no) resulted in a better prognostic index. The 5-year overall survival rates were 79%, 59% and 28% in the low-, intermediate- and high-risk groups for the extended FLIPI compared with 81%, 66% and 47% for the original FLIPI, respectively.
  
  
  CONCLUSIONS
  The performance of the FLIPI was validated in a population-based setting, but could significantly be improved by a more refined coding of age and by including the presence of CVD.
authors: Eindhoven Cancer Registry, Comprehensive Cancer Centre South, Eindhoven, The Netherlands. research@ikz.nl
authors: S A M
authors: SA
authors: van de Schans
authors: E W
authors: EW
authors: Steyerberg
authors: M R
authors: MR
authors: Nijziel
authors: G-J
authors: GJ
authors: Creemers
authors: M L
authors: ML
authors: Janssen-Heijnen
authors: D J
authors: DJ
authors: van Spronsen
mesh_terms: D000367:Age Factors; D002318:Cardiovascular Diseases / Q000150:complications; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D053208:Kaplan-Meier Estimate; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008198:Lymph Nodes / Q000473:pathology; D008224:Lymphoma, Follicular / Q000188:drug therapy* / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009367:Neoplasm Staging; D009426:Netherlands / Q000453:epidemiology; D044382:Population Groups; D011379:Prognosis; D012042:Registries; D012044:Regression Analysis; D015203:Reproducibility of Results; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D006454:Hemoglobins; D007770:L-Lactate Dehydrogenase