Han Albert Y, Kuan Edward C, Alonso Jose E, Badran Karam W, St John Maie A
1 Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA.
2 Jonsson Comprehensive Cancer Center, UCLA Medical Center, Los Angeles, California, USA.
Otolaryngol Head Neck Surg. 2017 May;156(5):870-876. doi: 10.1177/0194599817695808. Epub 2017 Mar 21.
Objectives To describe the incidence and determinants of survival of patients with nasopharyngeal lymphoma (NPL) between 1973 and 2012 using the Surveillance, Epidemiology, and End Results (SEER) database. Study Design Retrospective cohort study using a national database. Methods The SEER registry was used to calculate survival trends for patients with NPL between 1973 and 2012. Patient data were then analyzed with respect to histopathology, age, sex, race, histologic subtype, Ann Arbor stage, and whether radiation therapy was given. Overall survival (OS) and disease-specific survival (DSS) were calculated. Results A total of 1119 cases of NPL were identified. The cohort was composed of 58.8% males. The mean age at diagnosis was 59.3 years. The median OS was 8.2 years. B-cell non-Hodgkin's lymphomas (NHLs) accounted for most cases (77.5%), with natural killer (NK)/T-cell lymphomas comprising 6.0% of cases. A total of 41.5% patients received radiation therapy. OS at 2, 5, and 10 years was 70%, 57%, and 45%, respectively. On multivariate analysis, advanced age and NK/T-cell NHL histologic subtype were associated with worse OS and DSS, while radiation therapy was associated with improved OS and DSS (all P < .05). Conclusion With the exception of NK/T-cell NHL subtypes, NPL is associated with a fair prognosis, with younger age, low Ann Arbor stage, and radiation therapy being independent positive prognosticators for survival.
目的 使用监测、流行病学和最终结果（SEER）数据库描述1973年至2012年期间鼻咽淋巴瘤（NPL）患者的生存率及其影响因素。研究设计 使用国家数据库进行回顾性队列研究。方法 利用SEER登记处计算1973年至2012年期间NPL患者的生存趋势。然后根据组织病理学、年龄、性别、种族、组织学亚型、Ann Arbor分期以及是否接受放射治疗对患者数据进行分析。计算总生存期（OS）和疾病特异性生存期（DSS）。结果 共识别出1119例NPL病例。该队列中男性占58.8%。诊断时的平均年龄为59.3岁。中位OS为8.2年。B细胞非霍奇金淋巴瘤（NHL）占大多数病例（77.5%），自然杀伤（NK）/T细胞淋巴瘤占病例的6.0%。共有41.5%的患者接受了放射治疗。2年、5年和10年的OS分别为70%、57%和45%。多因素分析显示，高龄和NK/T细胞NHL组织学亚型与较差的OS和DSS相关，而放射治疗与改善的OS和DSS相关（所有P < 0.05）。结论 除NK/T细胞NHL亚型外，NPL的预后较好，年龄较小、Ann Arbor分期较低和放射治疗是生存的独立阳性预后因素。
