ArticleAnnals of hematology2026
A site-specific risk stratification model for extranodal diffuse large B-cell lymphoma in the oral cavity and maxillofacial region.
Article in Annals of hematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveExtranodal diffuse large B-cell lymphoma (DLBCL) of the oral cavity and maxillofacial region (OC-MR) is rare compared to Waldeyer’s ring (WR) DLBCL, characterized by marked aggressiveness and prognostic heterogeneity. 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.
methodWe conducted a retrospective analysis of 76 OC-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).
resultPatients with extranodal OC-MR DLBCL demonstrated significantly greater multisite involvement (p < 0.001) and worse clinical outcomes compared to WR-DLBCL, including shorter median overall survival (17 vs. 26 months, p = 0.0329), shorter progression free survival (13 vs. 25 months, p = 0.0136) and lower objective response rates (67.4% vs. 84.4%, p = 0.003). Hypoalbuminemia (< 37 g/L), elevated C-reactive protein (> 5.83 mg/L), and high Ki67 index (> 80%) 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, p < 0.001) and effectively stratified extranodal OC-MR DLBCL risk groups (p < 0.05).
conclusionExtranodal 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.
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