Tumor burden in Hodgkin's lymphoma can be reliably estimated from a few staging parameters

Gobbi,Paolo  G.; Bergonzi,Manuela; Bassi,Emilio; Merli,Francesco; Coriani,Chiara; Stelitano,Caterina; Iannitto,Emilio; Federico,Massimo

doi:10.3892/or.2012.1892

Tumor burden in Hodgkin's lymphoma can be reliably estimated from a few staging parameters

Authors:
- Paolo G. Gobbi
- Manuela Bergonzi
- Emilio Bassi
- Francesco Merli
- Chiara Coriani
- Caterina Stelitano
- Emilio Iannitto
- Massimo Federico
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Affiliations: Department of Internal Medicine and Gastroenterology, University of Pavia, IRCCS S. Matteo Policlinico Foundation, 27100 Pavia, Italy, Institute of Radiology, University of Pavia, IRCCS S. Matteo Policlinico Foundation, 27100 Pavia, Italy, Department of Hematology, Arcispedale S. Maria Nuova, 42100 Reggio Emilia, Italy, Department of Radiology, Arcispedale S. Maria Nuova, 42100 Reggio Emilia, Italy, Department of Hematology, Riuniti Hospital, 89100 Reggio Calabria, Italy, Department of Hematology, SS. Annunziata Hospital, 74100 Taranto, Italy, Department of Oncology, University of Modena and Reggio Emilia, Policlinico of Modena, 4110 Modena, Italy
Published online on: June 29, 2012 https://doi.org/10.3892/or.2012.1892
Pages: 815-820

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Abstract

The relative tumor burden (rTB), the tumor burden normalized to body surface area, is of prime clinical and prognostic value in Hodgkin's lymphoma. However, its measurement is rather complicated and a bedside computation cannot be proposed. We investigated the possibility of estimating, instead of measuring, rTB from elementary parameters of the initial staging. The rTB of 507 patients, treated with therapeutic protocols of the Gruppo Italiano Studio Linfomi according to their staging characteristics, was measured through their pre-therapy computed tomographies. The relationships between rTB and staging characteristics were analyzed with simple and multiple regressions both in a training sample (254 patients) for a selection of predictive parameters, and in a test sample (253 patients) for validation of the results. The number of involved sites, bulky mass and the IPI score were the variables best related to rTB. The resulting final equation {estimated rTB = -4.3 + 8.3 x IPI2 + 22.7 x [no. of involved sites (+3 if a bulky mass is present)]} provided the maximal approximation to the measured rTB (R2 =0.671). The validity of the equation was confirmed on the test sample and the predictive superiority of the estimated rTB over IPI was still evident in terms of failure-free survival in both groups of patients. The estimated rTB is accurate enough to retain most of the prognostic advantage of the measured rTB over the IPI score. It can be easily calculated, allows a valid approximation of the measured rTB, and can be proposed as a useful tool for clinical research and practice.

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