250874 Enhance Publishing | A Novel Prognostic Index and Treatment Efficacy Analysis for Primary Pulmonary Non-Hodgkin Lymphoma

This study aimed to establish and validate a novel international prognostic index (IPI) and evaluate the efficacy of different treatments for patients with primary pulmonary non-Hodgkin lymphoma (PPL).

Methods

This study was derived from the Surveillance, Epidemiology, and End Results (SEER) and three Chinese hospital databases. Cox regression was used to identify independent prognostic factors. Combined with the nomogram and IPI, we constructed a PPL-IPI and validated it using a concordance index (C-index) and a calibration curve.

For treatment, the inverse probability of treatment weighting was used to balance the differences between groups, and the Kaplan–Meier curve and log-rank test were used to compare the effects of different treatment modalities. Results: In total, 4,313 patients diagnosed between 2000 and 2019 in the SEER database were identified. Another 107 patients diagnosed between 2010 and 2021 were enrolled in this study.

The PPL-IPI included four worse factors: sex (male), histology (excluding mucosa-associated lymphoid tissue [MALT]), B symptoms (present), treatment (not accepted), and original IPI (C-index, 0.932 vs. 0.834). The 3-year survivals rate were 96% for low risk (0–2 factors); 82%, low intermediate risk (3–4 factors); 50%, high intermediate risk (5 factors); and 11.11%, high risk (6–9 factors) (p<0.0001).

In terms of treatment, chemotherapy worsened cancer-specific survival in patients with primary pulmonary MALT lymphoma (p<0.001). The efficacies of surgery and radiotherapy did not show a difference in primary pulmonary MALT and diffuse large B-cell lymphoma (all p>0.05). Conclusions: A novel PPL-IPI based on a large international multicenter cohort has an excellent predictive ability for patients with PPL.

Chemotherapy may not be recommended for patients with primary pulmonary MALT lymphomas. The attached file is the original data of Chinese cohort.2 Supplementary materialsAbstract: Supplementary figures and tables of the article.