Ayub Adil, Santana-Rodríguez Norberto, Raad Wissam, Bhora Faiz Y
Department of Thoracic Surgery, Icahn School of Medicine, New York, New York.
Department of Thoracic Surgery, Icahn School of Medicine, New York, New York.
J Surg Res. 2017 Jan;207:174-180. doi: 10.1016/j.jss.2016.08.079. Epub 2016 Aug 31.
Primary appendiceal lymphoma (PAL) is extremely rare with limited data available in literature. In this study, we sought to describe clinical features and identify factors affecting survival in patients with PAL using a large population cohort.
Surveillance, Epidemiology, and End Results database was queried for patients with PAL between 1973 and 2012. Patient demographics, tumor characteristics, and outcomes were assessed.
One hundred sixteen patients with PAL were included. The mean age (standard deviation) at diagnosis was 48 y (±22). PAL primarily afflicted males and white race. Diffuse large B-cell lymphoma was the most common histologic subtype (34.5%). Patients with Burkitt lymphoma presented at an earlier age compared with follicular lymphoma and diffuse large B-cell lymphoma (33 versus 59 and 53 y, respectively, [P < 0.001]). Mean overall survival (OS) for the whole cohort was 185 mo with a 5-y survival rate of 67%. No statistically significant survival difference was observed between gender, race and histologic subtypes. Right hemicolectomy conferred no survival benefit over appendectomy and/or partial colectomy (P = 0.501). In multivariate analysis, increasing age at diagnosis (P < 0.001) was associated with increased hazards of death while gender, race, tumor histology, disease stage, and nature of resection were not significantly associated with OS.
This is the largest series of PALs. Our results demonstrate that age at diagnosis is an independent predictor of poor survival. Gender, race, histologic subtypes have no effect on OS, and hemicolectomy provides no survival benefit over appendectomy and/or partial colectomy. Additional prospective, multicenter studies including details about chemotherapy and immunotherapy are needed to guide management.
原发性阑尾淋巴瘤（PAL）极为罕见，文献中的相关数据有限。在本研究中，我们试图利用一个大型人群队列来描述PAL患者的临床特征并确定影响其生存的因素。
查询监测、流行病学和最终结果数据库，以获取1973年至2012年间的PAL患者。评估患者的人口统计学特征、肿瘤特征和结局。
纳入了116例PAL患者。诊断时的平均年龄（标准差）为48岁（±22）。PAL主要累及男性和白种人。弥漫性大B细胞淋巴瘤是最常见的组织学亚型（34.5%）。与滤泡性淋巴瘤和弥漫性大B细胞淋巴瘤相比，伯基特淋巴瘤患者的发病年龄更早（分别为33岁、59岁和53岁，[P < 0.001]）。整个队列的平均总生存期（OS）为185个月，5年生存率为67%。在性别、种族和组织学亚型之间未观察到统计学上显著的生存差异。右半结肠切除术与阑尾切除术和/或部分结肠切除术相比，未显示出生存获益（P = 0.501）。在多变量分析中，诊断时年龄增加（P < 0.001）与死亡风险增加相关，而性别、种族、肿瘤组织学、疾病分期和切除性质与OS无显著关联。
这是最大的PAL系列研究。我们的结果表明，诊断时的年龄是生存不良 的独立预测因素。性别、种族、组织学亚型对OS无影响，半结肠切除术与阑尾切除术和/或部分结肠切除术相比未显示出生存获益。需要更多的前瞻性、多中心研究，包括化疗和免疫治疗的详细信息，以指导治疗。
