Prognostic evaluation models for primary thyroid lymphoma, based on the SEER database and an external validation cohort.
Prognostic evaluation models for primary thyroid lymphoma, based on the SEER database and an external validation cohort.
复制标题
DOI：
10.1007/s40618-021-01712-3
复制
发表时间：
2022-04
影响因子：
5.4
通讯作者：
He X
中科院分区：
文献类型：
--
作者：
Zhu Y;Yang S;He X
原发性甲状腺淋巴瘤(PTL)是一种罕见的恶性肿瘤，文献仅限于小的病例系列和病例报道。本研究旨在评估PTL患者的流行病学特征、生存和预后因素。我们分析了1983至2015年间来自监测、流行病学和最终结果数据库医疗记录的2215名PTL患者作为培训队列。我们从中国医学科学院肿瘤医院招募了105名患者参加外部验证队列。构建了预测1、5、10年总生存率(OS)和淋巴瘤特异性生存率(LSS)的诺模图。从1977年到1994年，甲状旁腺淋巴瘤发病率稳步上升，年变化率为3.2%(95%可信区间：1.2-5.2，P <； 0.05)。1、5、10年OS和LSS发生率分别为84.66%、71.61%、55.95%和90.5%、85.7%、82.2%。多因素COX回归分析显示，较短的OS与年龄 ≥ 60岁(HR，3.94；95%CI 3.31~4.69；P <； 0.001)、未婚状态(HR，1.55；95%CI 1.37~1.75；P <； 0.001)、Ann Arbor分期III~IV期(HR，1.55；95%CI 1.37~1.75；P = 0.020)、弥漫性大B细胞淋巴瘤(HR，2.6；T细胞性非霍奇金淋巴瘤(HR，3.53；95%CI1.12~11.10；P = 0.031)。在多变量竞争风险分析中，年龄、III-IV期、诊断年份、手术、放疗、化疗和组织学对PTL特有的死亡风险有很强的预测作用。为了分别估计1年、5年和10年的LSS和OS率，建立了诺模图。在验证队列中，结果也证实了效用。这项研究提出了第一个具有外部验证的预后模型，可以帮助临床医生识别高危PTL患者，以改善他们的预后。网上版载有补充材料，可在10.1007/s40618-021-01712-3查阅。
Primary thyroid lymphoma (PTL) is a rare malignancy, and the literature is limited to small case series and case reports. This study aimed to assess the epidemiologic characteristics, survival, and prognostic factors of patients with PTL. We analyzed 2215 PTL patients from the Surveillance, Epidemiology, and End Results database medical records, between 1983 and 2015, as the training cohort. We enrolled 105 patients from the Cancer Hospital, Chinese Academy of Medical Sciences, for the external validation cohort. The nomograms for predicting the 1-, 5-, and 10-year overall survival (OS) and lymphoma-specific survival (LSS) were constructed. PTL incidence steadily increased from 1977 to 1994, with an annual percentage change of 3.2% (95% confidence interval [CI]: 1.2–5.2, P < 0.05). The 1-, 5-, and 10-year OS and LSS rates were 84.66%, 71.61%, and 55.95%; and 90.5%, 85.7%, and 82.2%, respectively. Multivariate Cox regression analysis revealed that shorter OS association with age ≥ 60 years (hazard ratio [HR], 3.94; 95% CI 3.31–4.69; P < 0.001), unmarried status (HR, 1.55; 95% CI 1.37–1.75; P < 0.001), Ann Arbor stage III-IV (HR, 1.55; 95% CI 1.37–1.75; P = 0.020), diffuse large B-cell lymphoma (HR, 2.60; 95% CI 1.15–5.87; P = 0.022), and T cell non–Hodgkin lymphoma (HR, 3.53; 95% CI 1.12–11.10; P = 0.031). In the multivariate competing-risk analyzes, age, stages III-IV, year of diagnosis, surgery, radiation, chemotherapy, and histology were strongly predictive of PTL-specific risk of death. To estimate the 1-, 5-, and 10-year LSS and OS rates, respectively, nomograms were built. In the validation cohort, the results also confirmed the utility. This study presents the first prognostic model with an external validation that could help clinicians identify patients with high-risk PTL to improve their prognosis. The online version contains supplementary material available at 10.1007/s40618-021-01712-3.
登录
查看更多内容
影响因子：
3.8
作者：
Graff-Baker, Amanda;Roman, Sanziana A.;Sosa, Julie Ann
通讯作者：
Sosa, Julie Ann
影响因子：
5.2
作者：
Alzouebi, M.;Goepel, J. R.;Hancock, B. W.
通讯作者：
Hancock, B. W.
影响因子：
2.6
作者：
PYKE, CM;GRANT, CS;HAY, ID
通讯作者：
HAY, ID
DOI：
10.1097/01.coc.0000054891.30422.b5
发表时间：
2004-04-01
影响因子：
2.6
作者：
DiBiase, SJ;Grigsby, PW;Wasserman, TH
通讯作者：
Wasserman, TH
影响因子：
2.7
作者：
Niitsu, Nozomi;Okamoto, Masataka;Miura, Ikuo
通讯作者：
Miura, Ikuo