A risk stratification model for nodal peripheral T-cell lymphomas based on the NCCN-IPI and posttreatment Deauville score

Ho Young Yhim, Yong Park, Yeon Hee Han, Sungeun Kim, Sae Ryung Kang, Joon Ho Moon, Ju Hye Jeong, Ho Jin Shin, Keunyoung Kim, Yoon Seok Choi, Kunho Kim, Min Kyoung Kim, Eunjung Kong, Dae Sik Kim, Jae Seon Eo, Ji Hyun Lee, Do Young Kang, Won Sik Lee, Seok Mo Lee, Young Rok DoJun Soo Ham, Seok Jin Kim, Won Seog Kim, Joon Young Choi, Deok Hwan Yang, Jae Yong Kwak

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Abstract

Purpose: The aim of this study was to establish a risk-stratification model integrating posttreatment metabolic response using the Deauville score and the pretreatment National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI) in nodal PTCLs. Methods: We retrospectively analysed 326 patients with newly diagnosed nodal PTCLs between January 2005 and June 2016 and both baseline and posttreatment PET/CT data. The final model was validated using an independent prospective cohort of 79 patients. Results: Posttreatment Deauville score (1/2, 3, and 4/5) and the NCCN-IPI (low, low-intermediate, high-intermediate, and high) were independently associated with progression-free survival: for the Deauville score, the hazard ratios (HRs) were 1.00 vs. 2.16 (95% CI 1.47–3.18) vs. 7.86 (5.66–10.92), P < 0.001; and for the NCCN-IPI, the HRs were 1.00 vs. 2.31 (95% CI 1.20–4.41) vs. 4.42 (2.36–8.26) vs. 7.09 (3.57–14.06), P < 0.001. Based on these results, we developed a simplified three-group risk model comprising a low-risk group (low or low-intermediate NCCN-IPI with a posttreatment Deauville score of 1 or 2, or low NCCN-IPI with a Deauville score of 3), a high-risk group (high or high-intermediate NCCN-IPI with a Deauville score of 1/2 or 3, or low-intermediate NCCN-IPI with a Deauville score of 3), and a treatment failure group (Deauville score 4 or 5). This model was significantly associated with progression-free survival (5-year, 70.3%, 31.4%, and 4.7%; P < 0.001) and overall survival (5-year, 82.1%, 45.5%, and 14.7%; P < 0.001). Similar associations were also observed in the independent validation cohort. Conclusion: The risk-stratification model integrating posttreatment Deauville score and pretreatment NCCN-IPI is a powerful tool for predicting treatment failure in patients with nodal PTCLs.

Original languageEnglish
Pages (from-to)2274-2284
Number of pages11
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume45
Issue number13
DOIs
Publication statusPublished - 2018 Dec 1

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Keywords

  • International prognostic index
  • Peripheral T-cell lymphoma
  • PET/CT
  • Prognosis
  • Treatment

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Yhim, H. Y., Park, Y., Han, Y. H., Kim, S., Kang, S. R., Moon, J. H., Jeong, J. H., Shin, H. J., Kim, K., Choi, Y. S., Kim, K., Kim, M. K., Kong, E., Kim, D. S., Eo, J. S., Lee, J. H., Kang, D. Y., Lee, W. S., Lee, S. M., ... Kwak, J. Y. (2018). A risk stratification model for nodal peripheral T-cell lymphomas based on the NCCN-IPI and posttreatment Deauville score. European Journal of Nuclear Medicine and Molecular Imaging, 45(13), 2274-2284. https://doi.org/10.1007/s00259-018-4093-1