Background and purpose: A prognostic scoring system based on laboratory inflammation parameters, [Hemo-Eosinophils-Inflammation (HEI) index], including baseline hemoglobin level, the systemic inflam-matory index and eosinophil count was recently proposed in patients with squamous cell carcinoma of the anus (ASCC). HEI was shown to discriminate disease-free (DFS) and overall (OS) survival in ASCC patients treated with concurrent chemoradiation (CRT). We tested the accuracy of the model on a mul-ticentric cohort for external validation.Materials and methods: Patients treated with CRT were enrolled. The Kaplan-Meier curves for DFS and OS based on HEI risk group were calculated and the log-rank test was used. Cox proportional hazards models were used to assess the prognostic factors for DFS and OS. The exponential of the regression coefficients provided an estimate of the hazard ratio (HR). For model discrimination, we determined Harrell's C -index, Gonen & Heller K Index and the explained variation on the log relative hazard scale.Results: A total of 877 patients was available. Proportional hazards were adjusted for age, gender, tumor -stage, and chemotherapy. Two-year DFS was 77 %(95 %CI:72.0-82.4) and 88.3 %(95 %CI:84.8-92.0 %) in the HEI high-and low-risk groups. Two-year OS was 87.8 %(95 %CI:83.7-92.0) and 94.2 %(95 %CI:91.5- 97). Multivariate Cox proportional hazards model showed a HR = 2.02(95 %CI:1.25-3.26; p = 0.004) for the HEI high-risk group with respect to OS and a HR = 1.53(95 %CI:1.04-2.24; p = 0.029) for DFS. Harrel C-indexes were 0.68 and 0.66 in the validation dataset, for OS and DFS. Gonen-Heller K indexes were 0.67 and 0.71, respectively.Conclusion: The HEI index proved to be a prognosticator in ASCC patients treated with CRT. Model dis-crimination in the external validation cohort was acceptable.(c) 2022 Elsevier B.V. All rights reserved. Radiotherapy and Oncology 177 (2022) 9-15

External validation of a composite bio-humoral index in anal cancer patients undergoing concurrent chemoradiation / Franco, Pierfrancesco; Porreca, Annamaria; Mantello, Giovanna; Valvo, Francesca; Gasparini, Lucrezia; Slim, Najla; Manfrida, Stefania; De Felice, Francesca; Gerardi, Marianna A; Vagge, Stefano; Krengli, Marco; Palazzari, Elisa; Osti, Mattia Falchetto; Gonnelli, Alessandra; Catalano, Gianpiero; Pittoni, Patrizia; Ivaldi, Giovani B; Lupattelli, Marco; Rosetto, Maria Elena; Niespolo, Rita Marina; Guido, Alessandra; Durante, Oreste; Macchia, Gabriella; Munoz, Fernando; El Khouzai, Badr; Lucido, Maria Rosaria; Arcadipane, Francesca; Casadei Gardini, Andrea; Maria D'Angelillo, Rolando; Gambacorta, Maria Antonietta; Genovesi, Domenico; Di Nicola, Marta; Caravatta, Luciana. - In: RADIOTHERAPY AND ONCOLOGY. - ISSN 0167-8140. - 177:(2022), pp. 9-15. [10.1016/j.radonc.2022.10.015]

External validation of a composite bio-humoral index in anal cancer patients undergoing concurrent chemoradiation

De Felice, Francesca;Osti, Mattia Falchetto;
2022

Abstract

Background and purpose: A prognostic scoring system based on laboratory inflammation parameters, [Hemo-Eosinophils-Inflammation (HEI) index], including baseline hemoglobin level, the systemic inflam-matory index and eosinophil count was recently proposed in patients with squamous cell carcinoma of the anus (ASCC). HEI was shown to discriminate disease-free (DFS) and overall (OS) survival in ASCC patients treated with concurrent chemoradiation (CRT). We tested the accuracy of the model on a mul-ticentric cohort for external validation.Materials and methods: Patients treated with CRT were enrolled. The Kaplan-Meier curves for DFS and OS based on HEI risk group were calculated and the log-rank test was used. Cox proportional hazards models were used to assess the prognostic factors for DFS and OS. The exponential of the regression coefficients provided an estimate of the hazard ratio (HR). For model discrimination, we determined Harrell's C -index, Gonen & Heller K Index and the explained variation on the log relative hazard scale.Results: A total of 877 patients was available. Proportional hazards were adjusted for age, gender, tumor -stage, and chemotherapy. Two-year DFS was 77 %(95 %CI:72.0-82.4) and 88.3 %(95 %CI:84.8-92.0 %) in the HEI high-and low-risk groups. Two-year OS was 87.8 %(95 %CI:83.7-92.0) and 94.2 %(95 %CI:91.5- 97). Multivariate Cox proportional hazards model showed a HR = 2.02(95 %CI:1.25-3.26; p = 0.004) for the HEI high-risk group with respect to OS and a HR = 1.53(95 %CI:1.04-2.24; p = 0.029) for DFS. Harrel C-indexes were 0.68 and 0.66 in the validation dataset, for OS and DFS. Gonen-Heller K indexes were 0.67 and 0.71, respectively.Conclusion: The HEI index proved to be a prognosticator in ASCC patients treated with CRT. Model dis-crimination in the external validation cohort was acceptable.(c) 2022 Elsevier B.V. All rights reserved. Radiotherapy and Oncology 177 (2022) 9-15
2022
anal cancer; concurrent chemo-radiation; hemo-eosinophils-inflammation index; prognosis; radiotherapy
01 Pubblicazione su rivista::01a Articolo in rivista
External validation of a composite bio-humoral index in anal cancer patients undergoing concurrent chemoradiation / Franco, Pierfrancesco; Porreca, Annamaria; Mantello, Giovanna; Valvo, Francesca; Gasparini, Lucrezia; Slim, Najla; Manfrida, Stefania; De Felice, Francesca; Gerardi, Marianna A; Vagge, Stefano; Krengli, Marco; Palazzari, Elisa; Osti, Mattia Falchetto; Gonnelli, Alessandra; Catalano, Gianpiero; Pittoni, Patrizia; Ivaldi, Giovani B; Lupattelli, Marco; Rosetto, Maria Elena; Niespolo, Rita Marina; Guido, Alessandra; Durante, Oreste; Macchia, Gabriella; Munoz, Fernando; El Khouzai, Badr; Lucido, Maria Rosaria; Arcadipane, Francesca; Casadei Gardini, Andrea; Maria D'Angelillo, Rolando; Gambacorta, Maria Antonietta; Genovesi, Domenico; Di Nicola, Marta; Caravatta, Luciana. - In: RADIOTHERAPY AND ONCOLOGY. - ISSN 0167-8140. - 177:(2022), pp. 9-15. [10.1016/j.radonc.2022.10.015]
File allegati a questo prodotto
File Dimensione Formato  
Franco_External-validation_2022.pdf

solo gestori archivio

Note: article
Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 594.52 kB
Formato Adobe PDF
594.52 kB Adobe PDF   Contatta l'autore

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1676494
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 1
  • ???jsp.display-item.citation.isi??? 1
social impact