Evaluation of Chemotherapy Efficacy in Primary Gastric Diffuse Large B-cell Lymphoma on a Point-based Scoring System: A Multicenter Study

AIMS: To accurately evaluate the response to chemotherapy in primary gastric diffuse large B-cell lymphoma (DLBCL), which is essential for improving patient prognosis. Consequently, our objective was to develop and validate a point-based scoring system (PSS), utilising clinicopathological and quantitative computed tomography (CT) features, to assess the efficacy of chemotherapy in primary gastric DLBCL patients. MATERIALS AND METHODS: A total of 161 gastric DLBCL patients from two hospitals were retrospectively analysed. The quantitative CT features and clinicopathological of their tumours were systematically gathered. Subsequently, sequential univariate and multivariate analyses identified predictive factors associated with chemotherapy response. A PSS was developed using multivariate logistic regression analysis. The performance of the model was assessed using area under the curve (AUC), accuracy, sensitivity, specificity, recall, and F1 score. RESULTS: Post-chemotherapy lactate dehydrogenase, β2-microglobulin levels, lesion length, and the short-axis diameter of lymph nodes, along with staging, were identified as predictive factors in the scoring system for assessing chemotherapy efficacy in gastric DLBCL. Patients with a score ≥68 are considered to have metabolic progression of the disease; those with scores ranging from 4.0 to 68.0 are considered to show no metabolic response; scores from 0 to 4.0 indicate a partial metabolic response; and scores ≤0 signify a complete metabolic response. Utilising the scoring system, an AUC of 0.975 was recorded, accompanied by a 95% CI ranging from 0.940 to 1.000. CONCLUSION: This study presents a potentially practical and reliable PSS for assessing chemotherapy response in patients with gastric DLBCL.