Is the International Staging System superior to the Durie-Salmon staging system? A comparison in multiple myeloma patients undergoing autologous transplant.
Is the International Staging System superior to the Durie-Salmon staging system? A comparison in multiple myeloma patients undergoing autologous transplant.
复制标题
作者：
多发性骨髓瘤（MM）的国际分期系统（ISS）是Durie Salmon分期系统（DSS）的有效替代方法，可用于预测诊断时的生存率。我们通过分析1995年至2002年间729例患者的结果，比较了这些预测前期自体干细胞移植后结局的分期系统。中位随访时间为56个月，5年时非复发死亡率（NRM）、复发、无进展（PFS）和总生存率（OS）的单变量概率（95% CI）分别为7%、68%、25%和52%。DSS和ISS分期I、II、III期的中位总生存期分别为82、68、50和64、68、45个月。两种分期系统之间的一致性仅为36%。使用适合DSS和ISS分期的考克斯模型对分期系统进行了正式比较。对于DSS，I期与II期和II期与III期的PFS和OS相对风险存在显著差异，但对于ISS，仅II期与III期的PFS和OS相对风险存在显著差异。尽管两种系统均能预测PFS和OS;但在使用Brier评分进行的正式统计学比较中，DSS上级。然而，这两个系统都不能很好地预测结果，这表明需要结合其他预后标志物的新方案。
The International staging system (ISS) for multiple myeloma (MM) is a validated alternative to the Durie Salmon staging system (DSS) for predicting survival at diagnosis. We compared these staging systems for predicting outcomes after upfront autologous stem cell transplantation by analyzing the outcomes of 729 patients between 1995 and 2002. With a median follow-up of 56 months the univariate probabilities (95% CI) of non-relapse mortality (NRM), relapse, progression free (PFS) and overall survival (OS) at 5 years were 7%, 68%, 25% and 52%, respectively. The median overall survival for stages I, II, III by DSS and ISS were 82, 68, 50 and 64, 68, 45 months, respectively. The concordance between the two staging systems was only 36%. Staging systems were formally compared using Cox models fit with DSS and ISS stages. Relative risks of PFS and OS were significantly different for stages I vs. II and II vs. III for DSS but only for stages II vs. III for ISS. Although both systems were predictive of PFS and OS; the DSS was superior in formal statistical comparison using Brier Score. However, neither system was strongly predictive of outcomes indicating the need for newer schemes incorporating other prognostic markers.
登录
查看更多内容
影响因子：
4.8
作者：
Krejci, M;Buchler, T;Vorlicek, J
通讯作者：
Vorlicek, J
影响因子：
2
作者：
SPIEGELHALTER, DJ
通讯作者：
SPIEGELHALTER, DJ
影响因子：
3.7
作者：
KAPLAN, EL;MEIER, P
通讯作者：
MEIER, P
影响因子：
45.3
作者：
Greipp, PR;San Miguel, J;Westin, J
通讯作者：
Westin, J
影响因子：
6.5
作者：
Blade, Joan;Samson, Diana;Vesole, David
通讯作者：
Vesole, David