Nasioudis Dimitrios, Kampaktsis Polydoros N, Frey Melissa, Witkin Steven S, Holcomb Kevin
Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA; Surgery Working Group, Society of Junior Doctors, Athens, Greece.
Surgery Working Group, Society of Junior Doctors, Athens, Greece; Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
Gynecol Oncol. 2017 May;145(2):305-309. doi: 10.1016/j.ygyno.2017.02.043. Epub 2017 Mar 9.
Primary lymphoma of the female genital tract (PLFGT) is a rare entity. The aim of this population-based study was to elucidate the clinico-pathological, demographic characteristics and survival of women with PLFGT.
The Surveillance, Epidemiology, and End Results database was accessed and cases of PLFGT diagnosed between 1988 and 2012 were identified. Five-year overall (OS) and cancer-specific (CSS) survival rates were calculated with the Kaplan-Meier method. The influence of demographic and clinical parameters on survival was examined with the log-rank test. Factors independently associated with cancer-specific mortality were evaluated with a Cox proportional hazard model.
A total of 697 women with PLFGT were identified with a median age of 54years. The most prevalent histological subtypes were diffuse large B-cell (59.8%) and follicular (11.9%) lymphoma. Tumors were most commonly located in the ovary (37%), cervix (21.4%), and uterus (16.5%). According to the Ann Arbor staging system, 42.6% and 17.9% of cases had stage I and stage II disease, respectively. Cancer-directed surgery (CDS) was performed in the majority of cases (62.8%). Five-year OS and CSS were 70.2% and 75.2% respectively. Localized disease, premenopausal age and follicular histology were associated with superior cancer-specific mortality while CDS did not confer any mortality benefit.
This is the largest cohort of PLFGT presented in literature. While in our study surgical treatment was not associated with improved outcomes, larger multi-institutional studies should address the optimal management of women with PLFGT.
女性生殖道原发性淋巴瘤（PLFGT）是一种罕见疾病。本基于人群的研究旨在阐明PLFGT女性患者的临床病理特征、人口统计学特征及生存情况。
访问监测、流行病学和最终结果数据库，确定1988年至2012年间诊断为PLFGT的病例。采用Kaplan-Meier法计算5年总生存率（OS）和癌症特异性生存率（CSS）。采用对数秩检验研究人口统计学和临床参数对生存的影响。使用Cox比例风险模型评估与癌症特异性死亡率独立相关的因素。
共确定697例PLFGT女性患者，中位年龄为54岁。最常见的组织学亚型为弥漫性大B细胞淋巴瘤（59.8%）和滤泡性淋巴瘤（11.9%）。肿瘤最常见于卵巢（37%）、宫颈（21.4%）和子宫（16.5%）。根据Ann Arbor分期系统，分别有42.6%和17.9%的病例为I期和II期疾病。大多数病例（62.8%）接受了癌症导向手术（CDS）。5年OS和CSS分别为70.2%和75.2%。局限性疾病、绝经前年龄和滤泡性组织学与较低的癌症特异性死亡率相关，而CDS并未带来任何死亡率益处。
这是文献中报道的最大规模的PLFGT队列。虽然在我们的研究中手术治疗与改善预后无关，但更大规模的多机构研究应探讨PLFGT女性患者的最佳管理方案。
