title: Prognostic indicators for mycosis fungoides in a Greek population.
abstract: BACKGROUND
  Mycosis fungoides (MF) is an indolent cutaneous lymphoma with excellent prognosis at early stages and much poorer outcome during disease progression. Old age, male sex and folliculotropism have been proposed as relevant prognostic factors; however, their exact effect remains debatable.
  
  
  OBJECTIVE
  To evaluate MF prognostic indicators and survival rates in a Greek population.
  
  
  METHODS
  Prognostic variables affecting survival rates were studied in 473 patients with MF diagnosed and treated by two academic referral centres in Greece. Kaplan-Meier estimates were used to determine survival rates and progression. The Cox proportional hazards regression model was used to assess prognostic factors.
  
  
  RESULTS
  The mean age of diagnosis was 61·7 years (SD 16·33). Five-year disease-specific survival was 96% in patients with stage IA disease and 52% in patients with stage IIB disease. Univariate analysis certified that large-cell transformation, clonal rearrangements of the TCR gene, severe pruritus and presence of plaques were the most important prognostic factors. Folliculotropism altered disease progression only in patients with early-stage disease. The application of the Cutaneous Lymphoma International Prognostic Index (CLIPI) on our late-stage group failed to provide reliable evidence. The current Cutaneous Lymphoma International Consortium (CLIC) prognostic index can efficiently distinguish a low-risk from a high-risk group of patients. Tumour-Node-Metastasis-Blood (TNMB) staging was the most important prognostic factor for survival rates in multivariate analysis.
  
  
  CONCLUSIONS
  In our study we validated the current prognostic indicators for MF in a Greek population and identified new potential prognostic factors for survival outcome. Our findings contribute to the ongoing investigation of prognostic indicators of MF, further validation of which is highly needed through prospective studies and among different populations.
authors.affiliation: National and Kapodistrian University of Athens, Medical School, Athens, Greece.
authors.forename: V
authors.initials: V
authors.lastname: Nikolaou
authors.affiliation: National and Kapodistrian University of Athens, Medical School, Athens, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Papadavid
authors.affiliation: Aristotle University School of Medicine, Thessaloniki, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Patsatsi
authors.affiliation: National and Kapodistrian University of Athens, Medical School, Athens, Greece.
authors.forename: M
authors.initials: M
authors.lastname: Siakantaris
authors.affiliation: National and Kapodistrian University of Athens, Medical School, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Economidi
authors.affiliation: Department of Hemopathology, Evangelismos Hospital, Athens, Greece.
authors.forename: L
authors.initials: L
authors.lastname: Marinos
authors.affiliation: Aristotle University School of Medicine, Thessaloniki, Greece.
authors.forename: T
authors.initials: T
authors.lastname: Koletsa
authors.affiliation: Aristotle University School of Medicine, Thessaloniki, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Georgiou
authors.affiliation: National and Kapodistrian University of Athens, Medical School, Athens, Greece.
authors.forename: V
authors.initials: V
authors.lastname: Pappa
authors.affiliation: National and Kapodistrian University of Athens, Medical School, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Stratigos
authors.affiliation: National and Kapodistrian University of Athens, Medical School, Athens, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Antoniou
mesh_terms: D018450:Disease Progression; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000401:mortality*; D011379:Prognosis; D017678:Sex Distribution; D063507:Sexism; D012878:Skin Neoplasms / Q000401:mortality*; D015996:Survival Rate