Prognosis of primary thyroid lymphoma: Demographic, clinical, and pathologic predictors of survival in 1,408 cases
Prognosis of primary thyroid lymphoma: Demographic, clinical, and pathologic predictors of survival in 1,408 cases
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DOI：
10.1016/j.surg.2009.09.020
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发表时间：
2009-12-01
期刊：
影响因子：
3.8
通讯作者：
Sosa, Julie Ann
中科院分区：
文献类型：
--
作者：
Graff-Baker, Amanda;Roman, Sanziana A.;Sosa, Julie Ann
背景关于原发性甲状腺淋巴瘤（PTL）预后的数据很少，只有病例报告和机构系列报告。这是美国第一个基于人群的PTL研究。在SEER数据库中识别PTL患者。采用双变量（卡方检验、Kaplan-Meier检验和对数秩检验）和多变量（考克斯比例风险）分析来评估患者特征与生存率之间的关系。在32年的随访中（中位数为3.75年），共确定了1408例患者。平均年龄为66岁; 75%为女性，93%为白色。总体而言，98%的患者患有非霍奇金淋巴瘤; 68%的患者患有弥漫性大B细胞淋巴瘤，10%为滤泡性淋巴瘤，10%为边缘区淋巴瘤，3%为小淋巴细胞淋巴瘤。共有88%的人。I-II期疾病。中位生存期为9.3年。在双变量分析中，年龄较大，单身婚姻状况，II-IV期疾病，组织学（大B细胞，滤泡或其他非霍奇金），早期诊断，缺乏先前的恶性肿瘤，以及没有放疗/手术预测生存率较差。年龄！多因素分析显示，年龄> 80岁、晚期、未行放疗/手术、滤泡组织学上大B细胞者预后较差。高龄、晚期、组织学亚型和缺乏放疗/手术治疗与生存率差相关。甲状腺切除术仅对I期疾病患者有益。PTL的管理需要多学科合作。（Surgery 2009;146：1105- 115.）
Background. There is a paucity of data regarding prognosis of primary thyroid lymphoma (PTL), with only case reports and institutional series reported. This is the first population-based study of PTL in the United States.Methods. PTL patients were identified in the SEER database. Bivariate (chi(2) Kaplan-Meier, and log rank) and multivariate (Cox proportional hazards) analyses were used to assess the associations between patient characteristics and survival.Results. A total of 1, 408 patients were identified over 32 years of follow-up (median, 3.75 years). Mean age was 66 years; 75% were female and 93% white. Overall, 98% had non-Hodgkin's lymphoma; 68% had diffuse large B-cell, 10% follicular, 10% marginal zone, and 3% small lymphocytic. A total of 88% had. stage I-II disease. Median survival was 9.3 years. On bivariate analysis, older age, single marital status, stage II-IV disease, histology (large B-cell, follicular, or other non-Hodgkin's), earlier year of diagnosis, lack of prior malignancies, and, no radiation/surgery predicted worse survival. Age ! 80 years, advanced stage, no radiation/surgery, and large B-cell on follicular histology predicted worse prognosis in multivariate analysis.Conclusion. Older age, advanced stage, histologic subtype, and lack of radiation/surgical treatment are associated with worse survival. Thyroid resection offers benefit only for patients with stage I disease. Management of PTL requires multidisciplinary collaboration. (Surgery 2009;146:1105-15.)