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Multicenter Study
. 2022 Sep;11(18):3407-3416.
doi: 10.1002/cam4.4702. Epub 2022 Apr 29.

A novel prognostic nomogram for patients with extragastric mucosa-associated lymphoid tissue lymphoma: A multicenter study

Xiaoqian Li  1 , Huangming Hong  2 , He Huang  1 , Liqun Zou  3 , Zegeng Chen  1 , Zhihui Zhang  2 , Liling Zhang  4 , Xiaojie Fang  1 , Hongqiang Guo  5 , Ke Xie  6 , Ying Tian  1 , Suxia Lin  1 , Yungchang Chen  2 , Wei Zhang  2 , Yuyi Yao  1 , Fei Pan  1 , Huawei Weng  1 , Tongyu Lin  1   2
Affiliations
Multicenter Study

A novel prognostic nomogram for patients with extragastric mucosa-associated lymphoid tissue lymphoma: A multicenter study

Xiaoqian Li et al. Cancer Med. 2022 Sep.

Abstract

Background: The aim of this study was to explore predictors and construct a nomogram for risk stratification in primary extragastric mucosa-associated lymphoid tissue (MALT) lymphoma.

Methods: Extragastric MALT lymphoma cases newly diagnosed between November 2010 and April 2020 were assessed to construct a progression-free survival (PFS)-related nomogram. We also performed external validation of the nomogram in an independent cohort.

Results: We performed multivariate analyses of 174 patients from 3 hospitals who were included in the training cohort. Stage, hepatitis B virus surface antigen (HBsAg) status, and Ki67 expression were significantly associated with PFS. These three factors were used to construct a nomogram, which was shown to have a C-index of 0.89. Two risk groups (low risk and high risk) were identified by the prognostic model. The 5-year PFS was 98.9% for the low-risk group and 69.3% for the high-risk group (p < 0.001). The overall survival (OS) could also be effectively distinguished by the nomogram, resulting in an OS of 100% for the low-risk group and 94.6% for the high-risk group (p = 0.01). These results were validated and confirmed in an independent cohort with 165 patients from another three hospitals. The 5-year PFS rates were 94.8% and 66.7% for the low-risk and high-risk groups, respectively (p < 0.001). The 5-year OS rates were 97.9% and 88.4%, respectively (p = 0.016).

Conclusion: The nomogram could well distinguish the prognosis of low- and high-risk patients with extragastric MALT lymphoma and is thus recommended for clinical use.

Keywords: extragastric MALT lymphoma; nomogram; overall survival; prognosis; progression-free survival.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
(A) Nomogram for predicting the 3‐year and 5‐year PFS probability for patients with extragastric MALT lymphoma. (B) Nomogram for predicting the probability of recurrence
FIGURE 2
FIGURE 2
(A) Distribution of recurrence in the two groups; (B) Distribution of death in the two groups. (C) Sensitivity and specificity comparison between the novel nomogram and other factors in the training cohort. (D) Progression‐free survival probability curves of the nomogram training cohort according to the two risk groups defined by the nomogram
FIGURE 3
FIGURE 3
Progression‐free survival (PFS) and overall survival (OS) for patients with extragastric MALT lymphoma defined by the nomogram. (A and B) Training cohort patients. (C and D) Validation cohort patients
FIGURE 4
FIGURE 4
Progression‐free survival (PFS) and overall survival (OS) for all patients
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