Polychronidis Georgios, Feng Jincheng, Murtha-Lemekhova Anastasia, Heger Ulrike, Mehrabi Arianeb, Hoffmann Katrin
Department of General, Visceral and Transplant Surgery, Heidelberg University Clinic, Heidelberg, Germany.
Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
Int J Gen Med. 2022 Jan 8;15:393-406. doi: 10.2147/IJGM.S338066. eCollection 2022.
The study aimed to develop a nomogram to predict overall survival (OS) for patients with FLC using a national database.
The Surveillance, Epidemiology, and End Results database of the National Cancer Institute was reviewed to identify FLC cases with histological confirmation between 2004 and 2014. Cox proportional hazards models were used to identify factors associated with OS. The validation of the nomogram was performed using concordance index (C-index) and calibration curves.
Out of 170 cases with complete follow-up, 87 received surgery/ablation and 12 received transplantation with significantly higher OS than chemotherapy alone while transplantation combined with chemotherapy showed better survival than solely transplantation. The combination of surgery and chemotherapy showed worse OS than surgery alone. Survival was negatively influenced by T4 stadium (HR = 5.91), while young age and surgery were positive predictive factors. There was no influence of gender, ethnicity or nodal status on survival. The rate of AFP positivity was comparable with and without the presence of distal metastases.
FLC survival is greatly dependent upon appropriate surgical management irrespective of tumor stadium.
本研究旨在利用国家数据库开发一种列线图，以预测滤泡性淋巴瘤（FLC）患者的总生存期（OS）。
回顾美国国立癌症研究所的监测、流行病学和最终结果数据库，以确定2004年至2014年间经组织学证实的FLC病例。采用Cox比例风险模型确定与OS相关的因素。使用一致性指数（C指数）和校准曲线对列线图进行验证。
在170例有完整随访资料的病例中，87例接受了手术/消融治疗，12例接受了移植治疗，其OS显著高于单纯化疗，而移植联合化疗的生存期优于单纯移植。手术联合化疗的OS比单纯手术差。T4期对生存有负面影响（HR = 5.91），而年轻和手术是阳性预测因素。性别、种族或淋巴结状态对生存无影响。有无远处转移时甲胎蛋白（AFP）阳性率相当。
无论肿瘤分期如何，FLC的生存很大程度上取决于适当的手术治疗。
