Universität zu Köln

Klimm, B., Goergen, H., Fuchs, M., von Tresckow, B., Boell, B., Meissner, J., Glunz, A., Diehl, V., Eich, H. T., Engert, A. and Borchmann, P. (2013). Impact of risk factors on outcomes in early-stage Hodgkin's lymphoma: an analysis of international staging definitions. Ann. Oncol., 24 (12). S. 3070 - 3077. OXFORD: OXFORD UNIV PRESS. ISSN 1569-8041

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Abstract

In early-stage Hodgkin's lymphoma (HL), treatment according to the early favorable or unfavorable subgroup is guided by staging definitions, which differ between various study groups worldwide. We analyzed risk factors used in different international staging systems and their impact on the outcome of early-stage HL patients. In 1173 early-stage HL patients treated homogenously within the German Hodgkin Study Group (GHSG) trials HD10 and HD11, the impact of three staging systems developed and used by the GHSG, the European Organization for Research and Treatment of Cancer (EORTC), and the National Comprehensive Cancer Network (NCCN) in discriminating risk groups for progression-free survival (PFS) and overall survival (OS) was assessed and the relevance of their single risk factors was investigated. All the three staging systems defined an unfavorable risk group out of early-stage patients of comparable size (56%, 55%, and 57%), having a significantly poorer PFS and OS as compared with the corresponding favorable group; 5-year differences between early favorable and early unfavorable in terms of PFS were 9.4% (HR 2.61, 95% CI 1.74-3.91), 6.7% (HR 2.10, 95% CI 1.41-3.13), and 8.6% (HR 2.14, 95% CI 1.45-3.16) with the GHSG, EORTC, and NCCN definition, respectively. Sensitivity was high for all systems (84%, 79%, and 83%); however, there was a low specificity with high rates of false-positive results (1-specificity 54%, 53%, and 55%, respectively). Models of high sensitivity included risk factors associated with large tumor burden and high tumor activity. Most risk factors for tumor-specific end points were also predictive of OS. Differentiating between a favorable and an unfavorable risk group has significant impact on PFS and OS in early-stage HL patients in the modern treatment era. Risk-adapted treatment strategies using new risk factors with higher specificity are needed.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Klimm, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Goergen, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuchs, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED von Tresckow, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Boell, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Meissner, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Glunz, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Diehl, V. UNSPECIFIED UNSPECIFIED UNSPECIFIED Eich, H. T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Engert, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Borchmann, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-470956
DOI:	10.1093/annonc/mdt413
Journal or Publication Title:	Ann. Oncol.
Volume:	24
Number:	12
Page Range:	S. 3070 - 3077
Date:	2013
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1569-8041
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INVOLVED-FIELD RADIOTHERAPY; PROGNOSTIC-FACTORS; ELDERLY-PATIENTS; FINAL ANALYSIS; DISEASE; CHEMOTHERAPY; TRIAL; RADIATION; ONCOLOGY; ABVD Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47095