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. 2022 Sep 5:14:2639-2648.
doi: 10.2147/CMAR.S369086. eCollection 2022.

Clinical Features Analysis and Survival Nomogram of Primary Small Intestinal Diffuse Large B-Cell Lymphoma

Xiaohong Liu  1 , Dedong Cao  1 , Hui Liu  2 , Dong Ke  3 , Xiaokang Ke  4 , Ximing Xu  1
Affiliations

Clinical Features Analysis and Survival Nomogram of Primary Small Intestinal Diffuse Large B-Cell Lymphoma

Xiaohong Liu et al. Cancer Manag Res. .

Abstract

Purpose: This study aimed to analyze the clinical features and survival of primary small intestinal diffuse large B-cell lymphoma (PsI-DLBCL), and establish and independently validate a prognostic nomogram for individual risk prediction.

Patients and methods: Data for 24 patients from the Renmin Hospital of Wuhan University were used as an independent validation cohort, data for 1144 patients with PsI-DLBCL from the SEER database were randomly assigned to training (N=817) and internal validation (N=327) sets. The survival nomogram was constructed with the most significant factors associated with OS using Univariate and multivariate analyses on the training set. Decision curve analysis (DCA) was conducted. Internal validation was SEER validation set. Our cancer center cohort was used as an external validation set to further verify the survival nomogram.

Results: Five clinicopathological feature factors associated with OS of the training set yielded (age, marital status, Ann Arbor stage, surgery for primary site and chemotherapy), which were used to create a survival nomogram. Additionally, the calibration curves of the prognostic nomogram revealed good agreement between the predicted survival probabilities and the ground truth values. The stability of our survival nomogram was explained by internal and external validation data.

Conclusion: Our nomogram proposes the clinical and therapeutic factors affecting OS for patients with PsI-DLBCL. It shows that chemotherapy and surgery are beneficial to patients in the choice of treatment options. These results suggest that a survival nomogram may be better at predicting OS for PsI-DLBCL patients.

Keywords: SEER; large B-cell lymphoma; nomogram; non-Hodgkin; small intestine.

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Conflict of interest statement

The authors declare no conflicts of interest in this work.

Figures

Figure 1
Figure 1
A survival nomogram for predicting 1-year, 3-year and 5-year survival rates of primary small intestinal diffuse large B-cell lymphoma patients.
Figure 2
Figure 2
Decision curves analysis (DCA) for the survival nomogram to predict OS. (A) The DCA of nomogram for OS in training cohort; (B) the DCA of nomogram for OS in internal validation cohort; (C) the DCA of the survival nomogram for OS in external validation cohort.
Figure 3
Figure 3
The predictive performances of the survival nomogram for predicting 1-year, 3-year and 5-year OS in PsI-DLBCL. ROC curves displayed that this survival nomogram discriminated well in training set (A), internal validation set (B) and external validation set (C).
Figure 4
Figure 4
The calibration curves for predicting OS in PsI-DLBCL patients. (A–C) Calibration plots of 1-year, 3-year and 5-year mortality in training cohort; (D–F) calibration plots of 1-year, 3-year and 5-year mortality in internal validation cohort; (G–I) calibration plots of 1-year, 3-year and 5-year mortality in external validation cohort. Nomogram-predicted probabilities of OS were plotted on the x-axis, actual observed outcomes were plotted on the y-axis.
Figure 5
Figure 5
Kaplan–Meier curves of the high-risk and low-risk group of PsI-DLBCL patients stratified by the survival nomogram predicted probabilities in training set (A). internal validation set (B) and external validation set (C).
See this image and copyright information in PMC

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