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Survival outcomes and prognostic factors in mycosis fungoides/Sézary syndrome: validation of the revised International Society for Cutaneous Lymphomas/European Organisation for Research and Treatment of Cancer staging proposal.
- Source :
-
Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2010 Nov 01; Vol. 28 (31), pp. 4730-9. Date of Electronic Publication: 2010 Sep 20. - Publication Year :
- 2010
-
Abstract
- Purpose: We have analyzed the outcome of mycosis fungoides (MF) and Sézary syndrome (SS) patients using the recent International Society for Cutaneous Lymphomas (ISCL)/European Organisation for Research and Treatment of Cancer (EORTC) revised staging proposal.<br />Patients and Methods: Overall survival (OS), disease-specific survival (DSS), and risk of disease progression (RDP) were calculated for a cohort of 1,502 patients using univariate and multivariate models.<br />Results: The mean age at diagnosis was 54 years, and 71% of patients presented with early-stage disease. Disease progression occurred in 34%, and 26% of patients died due to MF/SS. A significant difference in survival and progression was noted for patients with early-stage disease having patches alone (T1a/T2a) compared with those having patches and plaques (T1b/T2b). Univariate analysis established that (1) advanced skin and overall clinical stage, increased age, male sex, increased lactate dehydrogenase (LDH), and large-cell transformation were associated with reduced survival and increased RDP; (2) hypopigmented MF, MF with lymphomatoid papulosis, and poikilodermatous MF were associated with improved survival and reduced RDP; and (3) folliculotropic MF was associated with an increased RDP. Multivariate analysis established that (1) advanced skin (T) stage, the presence in peripheral blood of the tumor clone without Sézary cells (B0b), increased LDH, and folliculotropic MF were independent predictors of poor survival and increased RDP; (2) large-cell transformation and tumor distribution were independent predictors of increased RDP only; and (3) N, M, and B stages; age; male sex; and poikilodermatous MF were only significant for survival.<br />Conclusion: This study has validated the recently proposed ISCL/EORTC staging system and identified new prognostic factors.
- Subjects :
- Adult
Age Factors
Aged
Analysis of Variance
Biomarkers, Tumor blood
Biopsy
Cell Transformation, Neoplastic pathology
Disease Progression
Disease-Free Survival
Europe
Female
Hair Follicle pathology
Humans
International Cooperation
L-Lactate Dehydrogenase blood
Male
Middle Aged
Neoplasm Staging standards
Prognosis
Regression Analysis
Risk Assessment
Risk Factors
Sex Factors
Societies, Medical
Survival Analysis
Treatment Outcome
Lymph Nodes pathology
Mycosis Fungoides mortality
Mycosis Fungoides pathology
Mycosis Fungoides therapy
Neoplasm Staging methods
Sezary Syndrome mortality
Sezary Syndrome pathology
Sezary Syndrome therapy
Skin Neoplasms mortality
Skin Neoplasms pathology
Skin Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1527-7755
- Volume :
- 28
- Issue :
- 31
- Database :
- MEDLINE
- Journal :
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 20855822
- Full Text :
- https://doi.org/10.1200/JCO.2009.27.7665