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基于人群的伯基特淋巴瘤患者生存预后因素:来自监测、流行病学和最终结果数据库的分析。

Population-based prognostic factors for survival in patients with Burkitt lymphoma: an analysis from the Surveillance, Epidemiology, and End Results database.

机构信息

Division of Hematology and Oncology, Alpert Medical School of Brown University, Rhode Island Hospital/The Miriam Hospital, Providence, Rhode Island.

出版信息

Cancer. 2013 Oct 15;119(20):3672-9. doi: 10.1002/cncr.28264. Epub 2013 Jul 30.

Abstract

BACKGROUND

Burkitt lymphoma (BL) is an aggressive but potentially curable lymphoma, previously described in small, single-institution studies. This study evaluated prognostic factors for survival in adult patients with BL and a potential outcome improvement over the past decade in a population-based cohort.

METHODS

Adult patients with BL diagnosed between 1998 and 2009 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Prognostic factors were identified in a multivariate model for relative survival (RS), and trends in survival were evaluated using period analysis.

RESULTS

The study cohort included 2284 patients, with a median age of 49 years and male predominance (2.6:1). Gastrointestinal tract and the head and neck were the most common sites of extranodal disease. Older age, black race/ethnicity, and advanced stage were associated with a worse survival. In the period analysis, trends in improved survival between 1998 and 2009 were seen, except for patients older than 60 years and black patients, whose survival did not improve. A prognostic score divided patients into 4 groups: low-risk (5-year RS: 71%), low-intermediate (5-year RS: 55%), high-intermediate (5-year RS: 41%), and high-risk (5-year RS: 29%; P  < .001).

CONCLUSIONS

The outcome of patients younger than 60 years with BL improved over the past decade. Age, race, and stage have a prognostic role for survival. The proposed score can help inform prognosis in newly diagnosed patients and stratify participants in future trials.

摘要

背景

伯基特淋巴瘤(BL)是一种侵袭性但可治愈的淋巴瘤,先前在小型单机构研究中描述过。本研究评估了在基于人群的队列中,过去十年中成年 BL 患者的生存预后因素,以及潜在的预后改善。

方法

从监测、流行病学和最终结果(SEER)数据库中选择了 1998 年至 2009 年间诊断的成年 BL 患者。使用相对生存率(RS)的多变量模型确定预后因素,并通过时期分析评估生存趋势。

结果

研究队列包括 2284 名患者,中位年龄为 49 岁,男性居多(2.6:1)。胃肠道和头颈部是最常见的结外疾病部位。年龄较大、黑种人/族裔和晚期与生存较差相关。在时期分析中,除了 60 岁以上患者和黑人患者,1998 年至 2009 年间生存率呈改善趋势。黑人患者的生存率没有改善。预后评分将患者分为 4 组:低危(5 年 RS:71%)、低中危(5 年 RS:55%)、高中危(5 年 RS:41%)和高危(5 年 RS:29%;P<0.001)。

结论

过去十年中,60 岁以下 BL 患者的预后有所改善。年龄、种族和分期对生存预后有一定的预测作用。该评分有助于为新诊断的患者提供预后信息,并为未来的试验分层参与者。

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