{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T13:46:22Z","timestamp":1793108782385,"version":"4.5.0"},"reference-count":36,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"21","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2022,7,20]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Baseline metabolic tumor volume (MTV) is a promising biomarker in diffuse large B-cell lymphoma (DLBCL). Our aims were to determine the best statistical relationship between MTV and survival and to compare MTV with the International Prognostic Index (IPI) and its individual components to derive the best prognostic model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>PET scans and clinical data were included from five published studies in newly diagnosed diffuse large B-cell lymphoma. Transformations of MTV were compared with the primary end points of 3-year progression-free survival (PFS) and overall survival (OS) to derive the best relationship for further analyses. MTV was compared with IPI categories and individual components to derive the best model. Patients were grouped into three groups for survival analysis using Kaplan-Meier analysis; 10% at highest risk, 30% intermediate risk, and 60% lowest risk, corresponding with expected clinical outcome. Validation of the best model was performed using four studies as a test set and the fifth study for validation and repeated five times.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      The best relationship for MTV and survival was a linear spline model with one knot located at the median MTV value of 307.9 cm\n                      <jats:sup>3<\/jats:sup>\n                      . MTV was a better predictor than IPI for PFS and OS. The best model combined MTV with age as continuous variables and individual stage as I-IV. The MTV-age-stage model performed better than IPI and was also better at defining a high-risk group (3-year PFS 46.3% v 58.0% and 3-year OS 51.5% v 66.4% for the new model and IPI, respectively). A regression formula was derived to estimate individual patient survival probabilities.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>A new prognostic index is proposed using MTV, age, and stage, which outperforms IPI and enables individualized estimates of patient outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco.21.02063","type":"journal-article","created":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T15:59:31Z","timestamp":1648742371000},"page":"2352-2360","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":156,"title":["Proposed New Dynamic Prognostic Index for Diffuse Large B-Cell Lymphoma: International Metabolic Prognostic Index"],"prefix":"10.1200","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0359-0328","authenticated-orcid":false,"given":"N. George","family":"Mikhaeel","sequence":"first","affiliation":[{"name":"Department of Clinical Oncology, Guy's Cancer Centre and School of Cancer and Pharmaceutical Sciences, King's College London University, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3889-0921","authenticated-orcid":false,"given":"Martijn W.","family":"Heymans","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6094-0016","authenticated-orcid":false,"given":"Jakoba J.","family":"Eertink","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Hematology, Cancer Center Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5454-2804","authenticated-orcid":false,"given":"Henrica C.W.","family":"de Vet","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Boellaard","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4034-9472","authenticated-orcid":false,"given":"Ulrich","family":"D\u00fchrsen","sequence":"additional","affiliation":[{"name":"Department of Hematology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Ceriani","sequence":"additional","affiliation":[{"name":"Department of Oncology, IOSI\u2014Oncology Institute of Southern Switzerland, Bellinzona; Universit\u00e0 della Svizzera Italiana, Bellinzona, Switzerland"},{"name":"SAKK\u2014Swiss Group for Clinical Cancer Research, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Schmitz","sequence":"additional","affiliation":[{"name":"Department of Hematology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3698-8121","authenticated-orcid":false,"given":"Sanne E.","family":"Wiegers","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Hematology, Cancer Center Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2230-3873","authenticated-orcid":false,"given":"Andreas","family":"H\u00fcttmann","sequence":"additional","affiliation":[{"name":"Department of Hematology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6735-8651","authenticated-orcid":false,"given":"Pieternella J.","family":"Lugtenburg","sequence":"additional","affiliation":[{"name":"Department of Hematology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Zucca","sequence":"additional","affiliation":[{"name":"Department of Oncology, IOSI\u2014Oncology Institute of Southern Switzerland, Bellinzona; Universit\u00e0 della Svizzera Italiana, Bellinzona, Switzerland"},{"name":"SAKK\u2014Swiss Group for Clinical Cancer Research, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9571-9362","authenticated-orcid":false,"given":"Gerben J.C.","family":"Zwezerijnen","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otto S.","family":"Hoekstra","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1074-5922","authenticated-orcid":false,"given":"Jos\u00e9e M.","family":"Zijlstra","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Hematology, Cancer Center Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2516-5288","authenticated-orcid":false,"given":"Sally F.","family":"Barrington","sequence":"additional","affiliation":[{"name":"King's College London and Guy's and St Thomas' PET Centre, School of Biomedical Engineering and Imaging Sciences, King's Health Partners, Kings College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"b1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199309303291402"},{"key":"b2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.09.137"},{"key":"b3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011795"},{"key":"b4","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.54.8800"},{"key":"b5","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2018181519"},{"key":"b6","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-08-038257"},{"key":"b7","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2015.1010078"},{"key":"b8","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2015.1022771"},{"key":"b9","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-09-524108"},{"key":"b10","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2019002729"},{"key":"b11","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019001201"},{"key":"b12","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.66.9440"},{"key":"b13","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-016-3315-7"},{"key":"b14","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-10-744292"},{"key":"b15","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.117.193946"},{"key":"b16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2019.09.027"},{"key":"b17","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2019003526"},{"key":"b18","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-07-795476"},{"key":"b19","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-018-3953-z"},{"key":"b20","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.119.227249"},{"key":"b21","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.119.238923"},{"key":"b22","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-014-2822-7"},{"key":"b23","doi-asserted-by":"publisher","DOI":"10.1002\/sim.2331"},{"key":"b24","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2021004467"},{"key":"b25","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.58.9846"},{"key":"b26","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16875"},{"key":"b27","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.03418"},{"key":"b28","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.76.8093"},{"key":"b29","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.2967\/jnumed.118.211607","volume":"59","author":"Boellaard R","year":"2018","journal-title":"J Nucl Med"},{"key":"b30","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1007\/978-3-319-19425-7","volume-title":"Regression Modeling Strategies with Applications to Linear Models, Logistic and Ordinal Regression, and Survival Analysis","author":"Harrell F","year":"2015","edition":"2"},{"key":"b31","doi-asserted-by":"publisher","DOI":"10.1002\/sim.5732"},{"key":"b32","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-05-577189"},{"key":"b33","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-011-1357-2"},{"key":"b34","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdw011"},{"key":"b35","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.119.229450"},{"key":"b36","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-021-05480-3"}],"container-title":["Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO.21.02063","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,15]],"date-time":"2022-07-15T18:00:54Z","timestamp":1657908054000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JCO.21.02063"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,20]]},"references-count":36,"journal-issue":{"issue":"21","published-print":{"date-parts":[[2022,7,20]]}},"alternative-id":["10.1200\/JCO.21.02063"],"URL":"https:\/\/doi.org\/10.1200\/jco.21.02063","relation":{},"ISSN":["0732-183X","1527-7755"],"issn-type":[{"value":"0732-183X","type":"print"},{"value":"1527-7755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,20]]},"assertion":[{"value":"2021-08-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-23","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}