Zackheim H S, Amin S, Kashani-Sabet M, McMillan A
Department of Dermatology, University of California, San Francisco, USA.
J Am Acad Dermatol. 1999 Mar;40(3):418-25. doi: 10.1016/s0190-9622(99)70491-3.
Although a number of studies have documented the long-term survival of patients with cutaneous T-cell lymphoma (CTCL), none have provided data as to the relative survival of all 4 skin stages.
We document survival of CTCL patients by T stage relative to that of an age-, sex-, and race-matched population.
The survival of 489 patients with CTCL registered since 1957 was compared with that of a California control population.
For stage T1 (< 10% skin involved) there was no significant difference between the observed and expected survivals. For the other 3 stages the observed survival was significantly inferior to that of the expected survival (P = .002). At 10 years the relative survivals were: T2 (10% or more skin involved) 67.4%, T3 (tumor stage) 39.2%, T4 (generalized erythroderma) 41.0%. T2 plaque stage patients had an inferior relative survival (P = .001), whereas T2 patch stage patients did not. Lymphadenopathy had an unfavorable impact on prognosis. There was a strong trend toward diagnosing CTCL at an earlier stage in more recent years. We estimate that from 15% to 20% of our patients died of CTCL or related complications.
The relative survival of CTCL patients worsens with increasing skin stage, although stages T3 and T4 had closely similar survivals. The great majority of patients with CTCL do not die of their disease.
尽管多项研究记录了皮肤T细胞淋巴瘤（CTCL）患者的长期生存情况，但尚无研究提供所有4个皮肤分期的相对生存率数据。
我们记录CTCL患者按T分期相对于年龄、性别和种族匹配人群的生存率。
将1957年以来登记的489例CTCL患者的生存率与加利福尼亚对照人群的生存率进行比较。
对于T1期（皮肤受累<10%），观察到的生存率与预期生存率之间无显著差异。对于其他3期，观察到的生存率显著低于预期生存率（P = 0.002）。10年时的相对生存率分别为：T2期（皮肤受累10%或更多）67.4%，T3期（肿瘤期）39.2%，T4期（泛发性红皮病）41.0%。T2斑块期患者的相对生存率较低（P = 0.001），而T2斑片期患者则不然。淋巴结病对预后有不利影响。近年来，CTCL的诊断有早期化的强烈趋势。我们估计，我们的患者中有15%至20%死于CTCL或相关并发症。
CTCL患者的相对生存率随皮肤分期增加而恶化，尽管T3期和T4期的生存率非常相似。绝大多数CTCL患者并非死于该病。
