Department of Internal Medicine, University of South Carolina School of Medicine, Columbia, SC.
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
Clin Lymphoma Myeloma Leuk. 2019 Jul;19(7):441-446. doi: 10.1016/j.clml.2019.03.026. Epub 2019 Apr 1.
Limited knowledge exists on the incidence, treatment patterns, and long-term outcomes of Langerhans cell sarcoma (LCS) in the United States.
We performed a retrospective study of LCS patients diagnosed between 2001 and 2014 using the Surveillance, Epidemiology, and End Results (SEER) and National Cancer Data Base (NCDB) databases. Incidence was calculated from SEER, and treatment patterns and outcomes were calculated from NCDB.
A total of 25 and 52 cases of LCS were reported to SEER and NCDB, respectively. The overall incidence of the disease was 0.2 per 10,000,000 and did not differ by race (P = .56) or sex (P = .33). The median age at diagnosis was 62 (range, 19-90) years. Of the 52 patients from NCDB, 20 (39%) received chemotherapy as first-line therapy, 24 (46%) received surgery, and 15 (29%) received radiotherapy. The 1-year overall survival (OS) rate was 62%, and the median OS was 19 months. After censoring the patients with bone marrow and reticuloendothelial system involvement, no significant difference in OS was noted between the patients who were managed with or without surgery (P = .75). Postsurgical radiation or chemotherapy were not associated with improvement in median OS (P = .25). Patients who were managed with radiotherapy had a better OS compared to those who received no radiotherapy (P = .03).
This dual-national registry study shows that LCS is extremely rare and has a poor prognosis. Radiotherapy may offer a survival advantage to patients with locoregional disease without bone marrow and reticuloendothelial system involvement.
在美国,关于朗格汉斯细胞肉瘤(LCS)的发病率、治疗模式和长期预后的知识有限。
我们使用监测、流行病学和最终结果(SEER)和国家癌症数据库(NCDB)数据库,对 2001 年至 2014 年间诊断的 LCS 患者进行了回顾性研究。发病率来自 SEER,治疗模式和结果来自 NCDB。
SEER 和 NCDB 分别报告了 25 例和 52 例 LCS 病例。该病的总发病率为 0.2/1000 万,且与种族(P=0.56)或性别(P=0.33)无关。诊断时的中位年龄为 62 岁(范围,19-90 岁)。来自 NCDB 的 52 名患者中,20 名(39%)接受化疗作为一线治疗,24 名(46%)接受手术,15 名(29%)接受放疗。1 年总生存率(OS)为 62%,中位 OS 为 19 个月。在排除骨髓和网状内皮系统受累患者后,手术与非手术治疗患者的 OS 无显著差异(P=0.75)。手术后放疗或化疗与中位 OS 改善无关(P=0.25)。接受放疗的患者与未接受放疗的患者相比,OS 更好(P=0.03)。
这项双国家注册研究表明,LCS 极为罕见,预后不良。对于无骨髓和网状内皮系统受累的局部区域疾病患者,放疗可能带来生存优势。