tetano
Editor, Senior Moderator
J Thorac Oncol
. 2022 Jan 24;S1556-0864(22)00033-8.
doi: 10.1016/j.jtho.2021.12.015. Online ahead of print.
A definitive prognostication system for patients with thoracic malignancies diagnosed with COVID-19: an update from the TERAVOLT registry
Jennifer G Whisenant[SUP] 1 [/SUP], Javier Baena[SUP] 2 [/SUP], Alessio Cortellini[SUP] 3 [/SUP], Li-Ching Huang[SUP] 1 [/SUP], Giuseppe Lo Russo[SUP] 4 [/SUP], Luca Porcu[SUP] 5 [/SUP], Selina K Wong[SUP] 1 [/SUP], Christine M Bestvina[SUP] 6 [/SUP], Matthew D Hellmann[SUP] 7 [/SUP], Elisa Roca[SUP] 8 [/SUP], Hira Rizvi[SUP] 7 [/SUP], Isabelle Monnet[SUP] 9 [/SUP], Amel Boudjemaa[SUP] 9 [/SUP], Jacobo Rogado[SUP] 10 [/SUP], Giulia Pasello[SUP] 11 [/SUP], Natasha B Leighl[SUP] 12 [/SUP], Oscar Arrieta[SUP] 13 [/SUP], Avinash Aujayeb[SUP] 14 [/SUP], Ullas Batra[SUP] 15 [/SUP], Ahmed Y Azzam[SUP] 16 [/SUP], Mojca Unk[SUP] 17 [/SUP], Mohammed A Azab[SUP] 18 [/SUP], Ardak N Zhumagaliyeva[SUP] 19 [/SUP], Carlos Gomez-Martin[SUP] 2 [/SUP], Juan B Blaquier[SUP] 20 [/SUP], Erica Geraedts[SUP] 21 [/SUP], Giannis Mountzios[SUP] 22 [/SUP], Gloria Serrano-Montero[SUP] 10 [/SUP], Niels Reinmuth[SUP] 23 [/SUP], Linda Coate[SUP] 24 [/SUP], Melina Marmarelis[SUP] 25 [/SUP], Carolyn J Presley[SUP] 26 [/SUP], Fred R Hirsch[SUP] 27 [/SUP], Pilar Garrido[SUP] 28 [/SUP], Hina Khan[SUP] 29 [/SUP], Alice Baggi[SUP] 30 [/SUP], Celine Mascaux[SUP] 31 [/SUP], Balazs Halmos[SUP] 32 [/SUP], Giovanni L Ceresoli[SUP] 33 [/SUP], Mary J Fidler[SUP] 34 [/SUP], Vieri Scotti[SUP] 35 [/SUP], Anne-Cécile Métivier[SUP] 36 [/SUP], Lionel Falchero[SUP] 37 [/SUP], Enriqueta Felip[SUP] 38 [/SUP], Carlo Genova[SUP] 39 [/SUP], Julien Mazieres[SUP] 40 [/SUP], Umit Tapan[SUP] 41 [/SUP], Julie Brahmer[SUP] 42 [/SUP], Emilio Bria[SUP] 43 [/SUP], Sonam Puri[SUP] 44 [/SUP], Sanjay Popat[SUP] 45 [/SUP], Karen L Reckamp[SUP] 46 [/SUP], Floriana Morgillo[SUP] 47 [/SUP], Ernest Nadal[SUP] 48 [/SUP], Francesca Mazzoni[SUP] 49 [/SUP], Francesco Agustoni[SUP] 50 [/SUP], Jair Bar[SUP] 51 [/SUP], Federica Grosso[SUP] 52 [/SUP], Virginie Avrillon[SUP] 53 [/SUP], Jyoti D Patel[SUP] 54 [/SUP], Fabio Gomes[SUP] 55 [/SUP], Ehab Ibrahim[SUP] 56 [/SUP], Annalisa Trama[SUP] 57 [/SUP], Anna C Bettini[SUP] 58 [/SUP], Fabrice Barlesi[SUP] 59 [/SUP], Anne-Marie Dingemans[SUP] 60 [/SUP], Heather Wakelee[SUP] 61 [/SUP], Solange Peters[SUP] 62 [/SUP], Leora Horn[SUP] 1 [/SUP], Marina Chiara Garassino[SUP] 6 [/SUP], Valter Torri[SUP] 5 [/SUP], TERAVOLT study group
Affiliations
Abstract
Background: Patients with thoracic malignancies are at increased risk for mortality from Coronavirus disease 2019 (COVID-19) and large number of intertwined prognostic variables have been identified so far.
Methods: Capitalizing data from the TERAVOLT registry, a global study created with the aim of describing the impact of COVID-19 in patients with thoracic malignancies, we used a clustering approach, a fast-backward step-down selection procedure and a tree-based model to screen and optimize a broad panel of demographics, clinical COVID-19 and cancer characteristics.
Results: As of April 15, 2021, 1491 consecutive evaluable patients from 18 countries were included in the analysis. With a mean observation period of 42 days, 361 events were reported with an all-cause case fatality rate of 24.2%. The clustering procedure screened approximately 73 covariates in 13 clusters. A further multivariable logistic regression for the association between clusters and death was performed, resulting in five clusters significantly associated with the outcome. The fast-backward step-down selection then identified seven major determinants of death ECOG-PS (OR 2.47 1.87-3.26), neutrophil count (OR 2.46 1.76-3.44), serum procalcitonin (OR 2.37 1.64-3.43), development of pneumonia (OR 1.95 1.48-2.58), c-reactive protein (CRP) (OR 1.90 1.43-2.51), tumor stage at COVID-19 diagnosis (OR 1.97 1.46-2.66) and age (OR 1.71 1.29-2.26). The ROC analysis for death of the selected model confirmed its diagnostic ability (AUC 0.78; 95%CI: 0.75 - 0.81). The nomogram was able to classify the COVID-19 mortality in an interval ranging from 8% to 90% and the tree-based model recognized ECOG-PS, neutrophil count and CRP as the major determinants of prognosis.
Conclusion: From 73 variables analyzed, seven major determinants of death have been identified. Poor ECOG-PS demonstrated the strongest association with poor outcome from COVID-19. With our analysis we provide clinicians with a definitive prognostication system to help determine the risk of mortality for patients with thoracic malignancies and COVID-19.
Keywords: COVID-19; NSCLC; TERAVOLT; cancer; mortality; registry; thoracic.
. 2022 Jan 24;S1556-0864(22)00033-8.
doi: 10.1016/j.jtho.2021.12.015. Online ahead of print.
A definitive prognostication system for patients with thoracic malignancies diagnosed with COVID-19: an update from the TERAVOLT registry
Jennifer G Whisenant[SUP] 1 [/SUP], Javier Baena[SUP] 2 [/SUP], Alessio Cortellini[SUP] 3 [/SUP], Li-Ching Huang[SUP] 1 [/SUP], Giuseppe Lo Russo[SUP] 4 [/SUP], Luca Porcu[SUP] 5 [/SUP], Selina K Wong[SUP] 1 [/SUP], Christine M Bestvina[SUP] 6 [/SUP], Matthew D Hellmann[SUP] 7 [/SUP], Elisa Roca[SUP] 8 [/SUP], Hira Rizvi[SUP] 7 [/SUP], Isabelle Monnet[SUP] 9 [/SUP], Amel Boudjemaa[SUP] 9 [/SUP], Jacobo Rogado[SUP] 10 [/SUP], Giulia Pasello[SUP] 11 [/SUP], Natasha B Leighl[SUP] 12 [/SUP], Oscar Arrieta[SUP] 13 [/SUP], Avinash Aujayeb[SUP] 14 [/SUP], Ullas Batra[SUP] 15 [/SUP], Ahmed Y Azzam[SUP] 16 [/SUP], Mojca Unk[SUP] 17 [/SUP], Mohammed A Azab[SUP] 18 [/SUP], Ardak N Zhumagaliyeva[SUP] 19 [/SUP], Carlos Gomez-Martin[SUP] 2 [/SUP], Juan B Blaquier[SUP] 20 [/SUP], Erica Geraedts[SUP] 21 [/SUP], Giannis Mountzios[SUP] 22 [/SUP], Gloria Serrano-Montero[SUP] 10 [/SUP], Niels Reinmuth[SUP] 23 [/SUP], Linda Coate[SUP] 24 [/SUP], Melina Marmarelis[SUP] 25 [/SUP], Carolyn J Presley[SUP] 26 [/SUP], Fred R Hirsch[SUP] 27 [/SUP], Pilar Garrido[SUP] 28 [/SUP], Hina Khan[SUP] 29 [/SUP], Alice Baggi[SUP] 30 [/SUP], Celine Mascaux[SUP] 31 [/SUP], Balazs Halmos[SUP] 32 [/SUP], Giovanni L Ceresoli[SUP] 33 [/SUP], Mary J Fidler[SUP] 34 [/SUP], Vieri Scotti[SUP] 35 [/SUP], Anne-Cécile Métivier[SUP] 36 [/SUP], Lionel Falchero[SUP] 37 [/SUP], Enriqueta Felip[SUP] 38 [/SUP], Carlo Genova[SUP] 39 [/SUP], Julien Mazieres[SUP] 40 [/SUP], Umit Tapan[SUP] 41 [/SUP], Julie Brahmer[SUP] 42 [/SUP], Emilio Bria[SUP] 43 [/SUP], Sonam Puri[SUP] 44 [/SUP], Sanjay Popat[SUP] 45 [/SUP], Karen L Reckamp[SUP] 46 [/SUP], Floriana Morgillo[SUP] 47 [/SUP], Ernest Nadal[SUP] 48 [/SUP], Francesca Mazzoni[SUP] 49 [/SUP], Francesco Agustoni[SUP] 50 [/SUP], Jair Bar[SUP] 51 [/SUP], Federica Grosso[SUP] 52 [/SUP], Virginie Avrillon[SUP] 53 [/SUP], Jyoti D Patel[SUP] 54 [/SUP], Fabio Gomes[SUP] 55 [/SUP], Ehab Ibrahim[SUP] 56 [/SUP], Annalisa Trama[SUP] 57 [/SUP], Anna C Bettini[SUP] 58 [/SUP], Fabrice Barlesi[SUP] 59 [/SUP], Anne-Marie Dingemans[SUP] 60 [/SUP], Heather Wakelee[SUP] 61 [/SUP], Solange Peters[SUP] 62 [/SUP], Leora Horn[SUP] 1 [/SUP], Marina Chiara Garassino[SUP] 6 [/SUP], Valter Torri[SUP] 5 [/SUP], TERAVOLT study group
Affiliations
- PMID: 35121086
- DOI: 10.1016/j.jtho.2021.12.015
Abstract
Background: Patients with thoracic malignancies are at increased risk for mortality from Coronavirus disease 2019 (COVID-19) and large number of intertwined prognostic variables have been identified so far.
Methods: Capitalizing data from the TERAVOLT registry, a global study created with the aim of describing the impact of COVID-19 in patients with thoracic malignancies, we used a clustering approach, a fast-backward step-down selection procedure and a tree-based model to screen and optimize a broad panel of demographics, clinical COVID-19 and cancer characteristics.
Results: As of April 15, 2021, 1491 consecutive evaluable patients from 18 countries were included in the analysis. With a mean observation period of 42 days, 361 events were reported with an all-cause case fatality rate of 24.2%. The clustering procedure screened approximately 73 covariates in 13 clusters. A further multivariable logistic regression for the association between clusters and death was performed, resulting in five clusters significantly associated with the outcome. The fast-backward step-down selection then identified seven major determinants of death ECOG-PS (OR 2.47 1.87-3.26), neutrophil count (OR 2.46 1.76-3.44), serum procalcitonin (OR 2.37 1.64-3.43), development of pneumonia (OR 1.95 1.48-2.58), c-reactive protein (CRP) (OR 1.90 1.43-2.51), tumor stage at COVID-19 diagnosis (OR 1.97 1.46-2.66) and age (OR 1.71 1.29-2.26). The ROC analysis for death of the selected model confirmed its diagnostic ability (AUC 0.78; 95%CI: 0.75 - 0.81). The nomogram was able to classify the COVID-19 mortality in an interval ranging from 8% to 90% and the tree-based model recognized ECOG-PS, neutrophil count and CRP as the major determinants of prognosis.
Conclusion: From 73 variables analyzed, seven major determinants of death have been identified. Poor ECOG-PS demonstrated the strongest association with poor outcome from COVID-19. With our analysis we provide clinicians with a definitive prognostication system to help determine the risk of mortality for patients with thoracic malignancies and COVID-19.
Keywords: COVID-19; NSCLC; TERAVOLT; cancer; mortality; registry; thoracic.