Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May;102(5):1141-1148.
doi: 10.1007/s00277-023-05165-x. Epub 2023 Mar 23.

Prognostic value of metabolic tumor volume of extranodal involvement in diffuse large B cell lymphoma

Kana Oiwa #  1   2 , Kei Fujita #  1   3 , Shin Lee  4   5 , Tetsuji Morishita  6   7 , Tetsuya Tsujikawa  8 , Eiju Negoro  1   9 , Takeshi Hara  3 , Hisashi Tsurumi  3 , Takanori Ueda  1 , Takahiro Yamauchi  1
Affiliations

Prognostic value of metabolic tumor volume of extranodal involvement in diffuse large B cell lymphoma

Kana Oiwa et al. Ann Hematol. 2023 May.

Abstract

Extranodal involvement predicts poor outcomes of diffuse large B cell lymphoma (DLBCL), but the impact of the metabolic tumor burden (MTV) of extranodal sites using positron emission tomography has not been clarified. This study aimed to assess the impact of extranodal MTV on overall survival (OS). We retrospectively analyzed 145 newly diagnosed DLBCL patients and verified the prognostic impact of each extranodal and nodal MTV. Multivariate Cox hazards modelling using both extranodal and nodal MTV as covariables identified extranodal MTV as a significant factor for OS (hazard ratio [HR] 1.072, 95% confidence interval [CI] 1.019-1.129, P = 0.008), but not nodal MTV. Multivariate Cox modelling using restricted cubic splines demonstrated that the impact of total MTV depends on the MTV of extranodal sites, not of nodal sites. When both the number and MTV of extranodal involvements were used as covariables, extranodal MTV remained a significant predictor of OS (HR 1.070, 95%CI 1.017-1.127, P = 0.009), but the number of extranodal sites did not. Extranodal MTV potentially had a more significant role on prognosis than nodal MTV. When considering prognostic impacts, the MTV of extranodal involvement is significantly more important than the number.

Keywords: Diffuse large B cell lymphoma; Extranodal involvement; Metabolic tumor burden; Positron emission tomography; Prognosis.

PubMed Disclaimer

Conflict of interest statement

T.Y. has received research funds and honoraria from Stargen, Boehringer Ingelheim, Mundipharma, Solasia, Pfizer, and Chugai Pharmaceutical. All other authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Association between each of the extranodal MTV (A), TMTV (B), and nodal MTV (C), and all-cause mortality risk using a multivariate Cox hazards model with restricted cubic spline with 3 knots. The solid line represents the log hazard ratio, and the shaded area is the 95% confidence interval. MTV = metabolic tumor volume, TMTV = total metabolic tumor volume
Fig. 2
Fig. 2
Plots of extranodal MTV by patients. MTV = metabolic tumor volume
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Morton LM, Wang SS, Devesa SS, Hartge P, Weisenburger DD, Linet MS. Lymphoma incidence patterns by WHO subtype in the United States, 1992–2001. Blood. 2006;107(1):265–276. doi: 10.1182/blood-2005-06-2508. - DOI - PMC - PubMed
    1. Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, Advani R, Ghielmini M, Salles GA, Zelenetz AD, Jaffe ES. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127(20):2375–2390. doi: 10.1182/blood-2016-01-643569. - DOI - PMC - PubMed
    1. Pettengell R, Schwenkglenks M, Bosly A. Association of reduced relative dose intensity and survival in lymphoma patients receiving CHOP-21 chemotherapy. Ann Hematol. 2008;87(5):429–430. doi: 10.1007/s00277-008-0447-2. - DOI - PMC - PubMed
    1. Kwak LW, Halpern J, Olshen RA, Horning SJ. Prognostic significance of actual dose intensity in diffuse large-cell lymphoma: results of a tree-structured survival analysis. J Clin Oncol. 1990;8(6):963–977. doi: 10.1200/jco.1990.8.6.963. - DOI - PubMed
    1. Sehn LH, Gascoyne RD. Diffuse large B-cell lymphoma: optimizing outcome in the context of clinical and biologic heterogeneity. Blood. 2015;125(1):22–32. doi: 10.1182/blood-2014-05-577189. - DOI - PubMed

Substances

LinkOut - more resources