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This study aims to develop a special risk stratification model for extranodal DLBCL in OC-MR to overcome the limitations of the conventional International Prognostic Index (IPI) to improve outcome prediction in this high-risk population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of 76\u00a0OC-MR DLBCL patients (43 extranodal and 33 WR-DLBCL) diagnosed between January 2015 and March 2022. Survival outcomes were assessed using Kaplan-Meier methodology with log-rank testing. Prognostic factors were identified through Cox regression and LASSO analysis, with model validation via concordance index (C-index).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      Patients with extranodal OC-MR DLBCL demonstrated significantly greater multisite involvement (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and worse clinical outcomes compared to WR-DLBCL, including shorter median overall survival (17 vs. 26 months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0329), shorter progression free survival (13 vs. 25 months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0136) and lower objective response rates (67.4% vs. 84.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). Hypoalbuminemia (&lt;\u200937\u00a0g\/L), elevated C-reactive protein (&gt;\u20095.83\u00a0mg\/L), and high Ki67 index (&gt;\u200980%) predicted poor prognosis. These clinicopathological biomarkers were integrated with IPI to develop the novel exploratory KACIPI model, which demonstrated a potentially improved discriminative ability than IPI (C-index 0.768 vs. 0.680,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and effectively stratified extranodal OC-MR DLBCL risk groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Extranodal OC-MR DLBCL exhibits distinct clinicopathological features and inferior survival outcomes. The exploratory KACIPI model may provide improved risk prediction for extranodal OC-MR DLBCL by incorporating tumor proliferation, inflammatory markers, nutritional status into conventional IPI score, enabling more accurate identification of high-risk patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00277-026-07029-6","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T04:54:50Z","timestamp":1777438490000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A site-specific risk stratification model for extranodal diffuse large B-cell lymphoma in the oral cavity and maxillofacial region"],"prefix":"10.1007","volume":"105","author":[{"given":"Yuyang","family":"Pang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yehua","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoli","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"issue":"2","key":"7029_CR1","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1007\/s00277-013-1856-4","volume":"93","author":"M Mian","year":"2014","unstructured":"Mian M, Capello D, Ventre MB, Grazio D, Svaldi M, Rossi A et al (2014) Early-stage diffuse large B cell lymphoma of the head and neck: clinico-biological characterization and 18 year follow-up of 488 patients (IELSG 23 study). 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