Department of Orthopedics, University of Miami Miller School of Medicine, Miami, Florida 33136, USA.
Cancer. 2010 Feb 15;116(4):871-9. doi: 10.1002/cncr.24828.
The low incidence of primary lymphoma of bone (PLB) has led to discrepancies in classification as well as difficulty in prognostication. The authors of this report used the Surveillance, Epidemiology, and End Results (SEER) database to analyze a large, population-based cohort of adult patients with this disease. The database provides a standardized classification and documentation of outcomes and enables a meaningful evaluation of prognostic factors.
The SEER database was used to identify all patients who were diagnosed with PLB from 1973 through 2005. Survival was analyzed with the Kaplan-Meier method, and the influence of clinical parameters on survival was analyzed with the log-rank test. A Cox proportional hazards model was used for multivariate analysis.
Fifteen hundred adult patients with PLB were analyzed. The 5-year and 10-year survival rates for adult patients were 58% and 45%, respectively. Multivariate analysis revealed that younger age and localized disease were independent predictors of survival. It is noteworthy that the incidence of disease, as determined by the annual percentage change, increased during the study period (P < .05).
This analysis of a large cohort of adults with PLB indicated that the only identifiable prognostic indicators were localized disease and younger age. The authors concluded that future treatment for patients with PLB need to be based on strict staging criteria and adherence to successful published protocols using collaborative clinical trials.
原发性骨淋巴瘤（PLB）的发病率较低，导致分类存在差异，且难以进行预后预测。本报告的作者使用监测、流行病学和最终结果（SEER）数据库，分析了一组大型、基于人群的成年 PLB 患者队列。该数据库提供了标准化的分类和结果记录，能够对预后因素进行有意义的评估。
使用 SEER 数据库确定了 1973 年至 2005 年间所有被诊断为 PLB 的患者。采用 Kaplan-Meier 法分析生存情况，采用对数秩检验分析临床参数对生存的影响。采用 Cox 比例风险模型进行多变量分析。
分析了 1500 例成年 PLB 患者。成年患者的 5 年和 10 年生存率分别为 58%和 45%。多变量分析显示，年龄较小和局限性疾病是生存的独立预测因素。值得注意的是，研究期间疾病的发病率（以年度百分比变化来衡量）有所增加（P <.05）。
对一组大型成年 PLB 患者的分析表明，唯一可识别的预后指标是局限性疾病和年龄较小。作者得出结论，未来 PLB 患者的治疗需要基于严格的分期标准，并遵循使用协作临床试验成功发表的方案。
