Department of Internal Medicine, Cleveland Clinic.
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
Am J Clin Oncol. 2019 May;42(5):454-458. doi: 10.1097/COC.0000000000000544.
Primary pancreatic lymphoma (PPL) is an extranodal manifestation of non-Hodgkin lymphoma originating in the pancreas, which constitutes <1% of all pancreatic neoplasms. Because of the rarity of the disease, most data on PPL are derived from case reports and small case series. To provide better insight into the epidemiology, treatment, and outcomes of these patients, we conducted an analysis of patients with PPL from the Surveillance, Epidemiology and End Results (SEER) database, which is presented in this study.
Patients with PPL were identified using the International Classification of Disease for Oncology, third edition histology codes for lymphoma (9590/3-9734/3), with pancreas (C25.0-C25.9) listed as the primary disease site. We collected data on patient demographics, year of diagnosis, primary tumor site, histology, first line of treatment received, and survival until death or last follow-up for the period 1973-2014.
Overall, 835 patients were included. The median (range) age of the study population was 67 (2 to 98) years. The median (95% confidence interval) overall survival for the cohort was 53 (37 to 73) months. On univariable analyses, age, stage, and use of chemotherapy were statistically associated with improved overall survival. Besides these factors, white race was associated with improved cause-specific survival on multivariable analysis.
This large population-based series describes PPL in detail. Younger age, white race, early stage, and initial treatment with chemotherapy are associated with improved survival in patients with PPL.
原发性胰腺淋巴瘤(PPL)是一种非霍奇金淋巴瘤的结外表现,起源于胰腺,构成所有胰腺肿瘤的<1%。由于该疾病罕见,大多数关于 PPL 的数据来自病例报告和小病例系列。为了更好地了解这些患者的流行病学、治疗和结果,我们对来自监测、流行病学和最终结果(SEER)数据库的 PPL 患者进行了分析,这在本研究中进行了介绍。
使用国际肿瘤疾病分类学,第 3 版组织学淋巴瘤代码(9590/3-9734/3),将胰腺(C25.0-C25.9)列为主要疾病部位,确定 PPL 患者。我们收集了患者人口统计学、诊断年份、原发肿瘤部位、组织学、一线治疗方案以及 1973 年至 2014 年期间的生存情况直至死亡或最后一次随访的数据。
总体而言,纳入了 835 名患者。研究人群的中位(范围)年龄为 67 岁(2 至 98 岁)。队列的中位(95%置信区间)总生存期为 53 个月(37 至 73 个月)。在单变量分析中,年龄、分期和化疗的使用与总生存的改善具有统计学相关性。除了这些因素外,在多变量分析中,白人种族与改善的特定原因生存相关。
这是一项大型基于人群的系列研究,详细描述了 PPL。年轻、白人种族、早期阶段和初始化疗治疗与 PPL 患者的生存改善相关。