Applicability and Prognostic Value of the New TNM Classification System in 135 Patients With Primary Cutaneous Anaplastic Large Cell Lymphoma
Applicability and Prognostic Value of the New TNM Classification System in 135 Patients With Primary Cutaneous Anaplastic Large Cell Lymphoma
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DOI：
10.1001/archdermatol.2009.280
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发表时间：
2009-12-01
影响因子：
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通讯作者：
Willemze, Rein
中科院分区：
文献类型：
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作者：
Benner, Marchina F.;Willemze, Rein
目的：在原发性皮肤间变性大细胞淋巴瘤（C-ALCL）患者中，检测新的TNM分类系统对除蕈样肉芽肿和Sezary综合征以外的原发性皮肤淋巴瘤的适用性和预后价值，并评估其他临床变量的预后意义，特别是表现部位。设计：回顾性队列分析。结果：T1期80例（59.3%），T2期37例（27.4%），T3期18例（13.3%）。中位随访时间为56个月（范围：11288个月）。T1期、T2期和T3期的5年疾病特异性生存率（DSS）分别为93%、93%和77%（P= 0.19）。与其他部位病变相比，腿部皮肤病变患者的5年DSS降低（腿部为82%，头颈部为95%，躯干为96%，手臂为95%; P= 0.23）。下肢受累患者（n = 32）的5年DSS显著差于无下肢受累患者（n = 103; 76% vs 96%; T分类调整后P= 0.03）。结论：新的TNM系统可以很好地应用于C-ALCL患者，并可能提供预后信息，特别是当结合临床表现部位时。腿部有皮肤病变的T2或T3疾病患者的生存率可能会降低，在随访期间需要密切监测。皮肤科医生2009;145（12）：1399-1404
Objectives: To test the applicability and prognostic value of the new TNM classification system for primary cutaneous lymphomas other than mycosis fungoides and Sezary syndrome in patients with primary cutaneous anaplastic large cell lymphoma (C-ALCL) and to evaluate the prognostic significance of other clinical variables, in particular the site of presentation.Design: Retrospective cohort analysis.Setting: Dutch Cutaneous Lymphoma Group database.Patients: One hundred thirty-five patients with C-ALCL.Main Outcome Measures: Clinical variables, including T category and site of presentation.Results: Eighty patients (59.3%) presented with T1 disease, 37 (27.4%) with T2 disease, and 18 (13.3%) with T3 disease. Median follow-up was 56 months (range, 11288 months). Five-year disease-specific survival (DSS) was 93% for T1 disease, 93% for T2 disease, and 77% for T3 disease (P=.19). Patients with skin lesions on a leg had reduced 5-year DSS compared with lesions on other sites (82% for leg vs; 95% for head and neck, 96% for trunk, and 95% for arm; P=.23). Patients with leg involvement (n = 32) had significantly worse 5-year DSS than did patients without leg involvement (n = 103; 76% vs 96%; P=.03 after adjustment for T category).Conclusions: The new TNM system can be applied well to patients with C-ALCL and may provide prognostic information, in particular when combined with site of presentation. Patients with T2 or T3 disease with skin lesions on the leg may have reduced survival and require close surveillance during follow-up. Arch Dermatol. 2009;145(12):1399-1404