title: FCG (FLIPI, Charlson comorbidity index, and histological grade) score is superior to FLIPI in advanced follicular lymphoma.
abstract: The Follicular Lymphoma International Prognostic Index (FLIPI) is widely used in the identification of risk groups among follicular lymphoma (FL) patients. The aim of the present study was to evaluate the prognostic value of FLIPI combined with the Charlson comorbidity index (CCI) and histological grade of lymphoma. 224 newly diagnosed FL patients (median age 56 years) treated with immunochemotherapy were retrospectively analysed. Low FLIPI had 21.0 % of patients, intermediate 28.1 % and high 46.9 %. 50.9 % of patients had no comorbidities. Only 7.1 % of patients had a high CCI score (≥2), while 25.9 % of patients were histological grade 3. Parameters that influenced overall survival were evaluated using Cox regression analysis, in which CCI, FLIPI and histological grade (p < 0.05) retained prognostic significance. By combining these parameters, we have developed the FCG score, which incorporates FLIPI, CCI, and histological grade. This score defines three risk categories (low: 41.5 %; intermediate: 37.5 %; high: 13.4 %), associated with significantly different survival (p < 0.0001); this consequently improves discriminative power by 9.1 % compared to FLIPI. FCG score represents a possible new prognostic index, highlighting the role of the patient's clinical state and the histological characteristics of disease, as indicated by comorbidity index and histological grade of lymphoma.
authors.affiliation: Clinic for Haematology, Clinical Centre of Serbia, Koste Todorovica 2 str, 11000, Belgrade, Serbia. bimihalje2802@gmail.com.|Faculty of Medicine, University of Belgrade, Belgrade, Serbia. bimihalje2802@gmail.com.
authors.forename: Biljana
authors.initials: B
authors.lastname: Mihaljevic
authors.affiliation: Clinic for Haematology, Clinical Centre of Serbia, Koste Todorovica 2 str, 11000, Belgrade, Serbia.
authors.forename: Jelena
authors.initials: J
authors.lastname: Jelicic
authors.affiliation: Clinic for Haematology, Clinical Centre of Serbia, Koste Todorovica 2 str, 11000, Belgrade, Serbia.|Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Bosko
authors.initials: B
authors.lastname: Andjelic
authors.affiliation: Clinic for Haematology, Clinical Centre of Serbia, Koste Todorovica 2 str, 11000, Belgrade, Serbia.|Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Darko
authors.initials: D
authors.lastname: Antic
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia.|Clinical Hospital Centre "Bezanijska Kosa", Belgrade, Serbia.
authors.forename: Olivera
authors.initials: O
authors.lastname: Markovic
authors.affiliation: Clinic for Oncology, Clinical Centre Nis, Nis, Serbia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Petkovic
authors.affiliation: Department of Histopathology, Clinical Centre of Serbia, Belgrade, Serbia.
authors.forename: Maja Perunicic
authors.initials: MP
authors.lastname: Jovanovic
authors.affiliation: Department of Statistics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Goran
authors.initials: G
authors.lastname: Trajkovic
authors.affiliation: Clinic for Haematology, Clinical Centre of Serbia, Koste Todorovica 2 str, 11000, Belgrade, Serbia.|Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Jelena
authors.initials: J
authors.lastname: Bila
authors.affiliation: Clinic for Haematology, Clinical Centre of Serbia, Koste Todorovica 2 str, 11000, Belgrade, Serbia.
authors.forename: Vladislava
authors.initials: V
authors.lastname: Djurasinovic
authors.affiliation: Clinic for Haematology, Clinical Centre of Serbia, Koste Todorovica 2 str, 11000, Belgrade, Serbia.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Sretenovic
authors.affiliation: Clinic for Haematology, Clinical Centre of Serbia, Koste Todorovica 2 str, 11000, Belgrade, Serbia.
authors.forename: Vojin
authors.initials: V
authors.lastname: Vukovic
authors.affiliation: Clinic for Haematology, Clinical Centre of Serbia, Koste Todorovica 2 str, 11000, Belgrade, Serbia.
authors.forename: Mihailo
authors.initials: M
authors.lastname: Smiljanic
authors.affiliation: Clinic for Haematology, Clinical Centre of Serbia, Koste Todorovica 2 str, 11000, Belgrade, Serbia.|Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Milena Todorovic
authors.initials: MT
authors.lastname: Balint
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015897:Comorbidity; D005260:Female; D006801:Humans; D007167:Immunotherapy; D008198:Lymph Nodes / Q000473:pathology; D008224:Lymphoma, Follicular / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents
keywords: Comorbidity index; FLIPI; Follicular lymphoma; Histological grade