Prognostic utility of a geriatric nutritional risk index in combination with a comorbidity index in elderly patients with diffuse large B cell lymphoma
| Autor: | Hikaru Tsukasaki, Takanori Ueda, Takahiro Yamauchi, Osamu Yamamura, Kana Oiwa, Tetsuji Morishita, Eiju Negoro, Kei Fujita, Shin Lee |
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| Rok vydání: | 2020 |
| Předmět: |
Oncology
Male medicine.medical_specialty Multivariate statistics Nutritional Status Comorbidity 03 medical and health sciences 0302 clinical medicine International Prognostic Index Risk Factors Internal medicine Nutritional risk index medicine Humans Geriatric Assessment Aged Retrospective Studies Aged 80 and over Receiver operating characteristic business.industry Proportional hazards model Age Factors Hematology medicine.disease Prognosis Survival Analysis Net reclassification improvement 030220 oncology & carcinogenesis Cohort Female Lymphoma Large B-Cell Diffuse business Diffuse large B-cell lymphoma 030215 immunology |
| Zdroj: | British journal of haematologyReferences. 192(1) |
| ISSN: | 1365-2141 |
| Popis: | Reflecting the increasing risk in elderly patients with diffuse large B cell lymphoma (DLBCL), prognostic predictors other than the International Prognostic Index have attracted more attention. This study presents the first analysis of the prognostic utility of the Geriatric Nutritional Risk Index (GNRI) in combination with the Charlson Comorbidity Index (CCI) for overall survival (OS) in elderly DLBCL patients. A multicentre retrospective was conducted on a cohort of 451 patients (≥65 years). The GNRI and CCI were independent predictors in a multivariate Cox proportional hazard model. There was a nonlinear correlation between the GNRI and OS in a Cox model with restricted cubic spline. Multivariate receiver operating characteristic curves showed a significant improvement in prediction accuracy when the GNRI was added to CCI. Adding the GNRI to CCI yielded a significant category-free net reclassification improvement (0·556; 95% CI: 0·378-0·736, P < 0·001) and integrated discrimination improvement (0·094; 95% CI: 0·067-0·122, P < 0·001). The decision curve analysis demonstrated the clinical net benefit associated with the adoption of the GNRI. The GNRI was not only a predictor of OS but also remarkably improved the prognosis prediction accuracy when incorporated with the CCI, having the ability to stratify the prognosis of elderly DLBCL patients. |
| Databáze: | OpenAIRE |
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