Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
Br J Ophthalmol. 2023 Oct;107(10):1560-1566. doi: 10.1136/bjo-2022-321656. Epub 2022 Aug 1.
BACKGROUND/AIMS: Extranodal marginal zone lymphoma of ocular adnexa (OA-EMZL) is the most frequent type of ocular adnexal lymphomas, with a high rate of disease recurrence. Precise patient stratification based on disease recurrence is understudied. This study aims to identify risk factors of distant recurrence (DR) and local recurrence (LR) to construct a prognostic model optimising rapid decision of therapeutic strategies.
A total of 104 patients diagnosed with OA-EMZL between January 2011 and February 2020 were enrolled. Propensity score matching was performed for DR and LR groups. A nomogram was generated using a multivariate Cox proportional hazards model.
After matching, different independent risk factors of DR and LR were identified. Monocyte percentage (p=0.015) and M category >0 (p=0.043) were significant independent risk factors of DR. Epiphora (p<0.001) was the significant independent risk factor of LR. Three factors (monocyte percentage, M category >0, age >60) were integrated into the nomogram to predict the risk of DR. It had a relatively better discriminative ability for distant recurrence-free survival (C-index: 3-year, 0.784; 6-year, 0.801) than IPI score (C-index: 3-year, 0.663; 6-year, 0.673) in the cohort of all patients.
Our analyses suggested DR and LR as two distinct prognostic events, and additionally identified novel risk factors of them. The nomogram may serve as a practical tool for the prognostic estimation and rapid decision of therapeutic strategies for patients with OA-EMZL.
背景/目的：眼附属器边缘区淋巴瘤（OA-EMZL）是眼附属器淋巴瘤中最常见的类型，疾病复发率较高。基于疾病复发的精确患者分层研究较少。本研究旨在确定远处复发（DR）和局部复发（LR）的危险因素，构建一个优化治疗策略快速决策的预后模型。
纳入 2011 年 1 月至 2020 年 2 月期间诊断为 OA-EMZL 的 104 例患者。对 DR 和 LR 组进行倾向评分匹配。使用多变量 Cox 比例风险模型生成列线图。
匹配后，确定了 DR 和 LR 的不同独立危险因素。单核细胞百分比（p=0.015）和 M 分期>0（p=0.043）是 DR 的显著独立危险因素。溢泪（p<0.001）是 LR 的显著独立危险因素。三个因素（单核细胞百分比、M 分期>0、年龄>60）被纳入列线图以预测 DR 的风险。与 IPI 评分（所有患者队列中，3 年的 C 指数：0.663；6 年的 C 指数：0.673）相比，该列线图对远处无复发生存率（3 年的 C 指数：0.784；6 年的 C 指数：0.801）具有更好的区分能力。
我们的分析表明 DR 和 LR 是两种不同的预后事件，并进一步确定了它们的新危险因素。该列线图可能成为评估 OA-EMZL 患者预后和快速决策治疗策略的实用工具。
