Prognostic indicators for mycosis fungoides in a Greek population. (10th April 2017)

• Record Type: Journal Article
• Authors: Nikolaou, V.; Papadavid, E.; Patsatsi, A.; Siakantaris, M.; Economidi, A.; Marinos, L.; Koletsa, T.; Georgiou, E.; Pappa, V.; Stratigos, A.; Antoniou, C.
• Is Part Of: British journal of dermatology. Volume 176:Number 5(2017)
• Page Start: 1321
• Page End: 1330
• Publication Date: 2017-04-10
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.15000
• Languages: English
• ISSNs: 0007-0963

Abstract

Summary: Background: Mycosis fungoides (MF) is an indolent cutaneous lymphoma with excellent prognosis at early stages and much poorer outcome during disease progression. Old age, male sex and folliculotropism have been proposed as relevant prognostic factors; however, their exact effect remains debatable. Objectives: To evaluate MF prognostic indicators and survival rates in a Greek population. Methods: Prognostic variables affecting survival rates were studied in 473 patients with MF diagnosed and treated by two academic referral centres in Greece. Kaplan–Meier estimates were used to determine survival rates and progression. The Cox proportional hazards regression model was used to assess prognostic factors. Results: The mean age of diagnosis was 61·7 years (SD 16·33). Five‐year disease‐specific survival was 96% in patients with stage IA disease and 52% in patients with stage IIB disease. Univariate analysis certified that large‐cell transformation, clonal rearrangements of the TCR gene, severe pruritus and presence of plaques were the most important prognostic factors. Folliculotropism altered disease progression only in patients with early‐stage disease. The application of the Cutaneous Lymphoma International Prognostic Index (CLIPI) on our late‐stage group failed to provide reliable evidence. The current Cutaneous Lymphoma International Consortium (CLIC) prognostic index can efficiently distinguish a low‐risk from a high‐risk group of patients. Tumour–Node–Metastasis–Blood (TNMB) staging was the most important prognostic factor for survival rates in multivariate analysis. Conclusions: In our study we validated the current prognostic indicators for MF in a Greek population and identified new potential prognostic factors for survival outcome. Our findings contribute to the ongoing investigation of prognostic indicators of MF, further validation of which is highly needed through prospective studies and among different populations. Abstract : What's already known about this topic? The influence of prognostic indicators on survival in patients with mycosis fungoides (MF) is less well described compared with systemic lymphomas. What does this study add? Current prognostic indexes [Cutaneous Lymphoma International Prognostic Index (CLIPI), Cutaneous Lymphoma International Consortium (CLIC)] can identify a low‐risk from an intermediate/high‐risk group of patients. No index is efficient enough to distinguish intermediate‐risk from high‐risk groups. Folliculotropism influences disease progression only in early‐stage disease. Earlier diagnosis may be related to improved outcome in patients with MF. Patients with stage Nx disease have an increased risk of disease progression and poorer survival rates. Histological examination of any clinically suspicious node is recommended. Respond to this article