Clinically assessed mycosis fungoides tumor burden index as a prognostic marker in tumor-stage mycosis fungoides: a retrospective cohort study

Arch Dermatol Res. 2024 Nov 22;317(1):42. doi: 10.1007/s00403-024-03496-x.

Abstract

Prognostic markers are needed for tumor-stage mycosis fungoides (MF) because of their variable prognosis. The objectives of this study were to explore prognostic markers for tumor-stage MF and assess the prognostic significance of clinically assessed MF tumor burden index (MTBI). MTBI was devised to consider the tumor size ≥ 2 cm, number ≥ 5, ulcers, and body surface area ≥ 50%. The prognostic value of MTBI and other potential markers derived from blood tests and skin biopsy were evaluated retrospectively using a tertiary medical center database. We included 38 cases of tumor-stage MF. The mean age was 52.1 years, and the male-to-female ratio was 2.5:1. In multivariable analysis, MTBI ≥ 3 (adjusted hazard ratio, 9.41; 95% confidence interval, 1.13-78.15) was significantly associated with worse disease-specific survival. Ulcers were the only MTBI constituent significantly associated with survival. Among other markers, elevated lactate dehydrogenase level was associated with a worse disease-specific survival. Neutrophil-lymphocyte-ratio, pan-inflammation-value, CD30 positivity, Ki-67 index, large cell transformation, and monoclonal T-cell receptor gene rearrangement were not associated with prognosis. In conclusion, MTBI is useful and promising prognostic marker for tumor-stage MF.

Keywords: Cutaneous T-cell lymphoma; Mycosis fungoides; Prognosis; Survival; Tumor.

MeSH terms

  • Adult
  • Aged
  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / metabolism
  • Biopsy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mycosis Fungoides* / diagnosis
  • Mycosis Fungoides* / mortality
  • Mycosis Fungoides* / pathology
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Skin / pathology
  • Skin Neoplasms* / diagnosis
  • Skin Neoplasms* / mortality
  • Skin Neoplasms* / pathology
  • Tumor Burden*

Substances

  • Biomarkers, Tumor