Chi Kaiyi, Zhou Ruoyun, Luo Zehao, Zhao Hongjun, Jiang Yanting, He Baixin, Li Yemin, Chen Dongting, Feng Manting, Liang Yinglan, Yang Wenting, Liu Ruisi, Yao Dunchen, Lin Xiaozhen, Xu Xiuhong
Department of Clinical Medicine, The Second Clinical College of Guangzhou Medical University, Guangzhou, China.
Cardiovascular Medicine and Cardio-Oncology Group, Medical Exploration and Translation Team, Guangzhou, China.
Front Oncol. 2023 Feb 8;13:1096027. doi: 10.3389/fonc.2023.1096027. eCollection 2023.
The study aimed to evaluate the non-cancer-specific death risk and identify the risk factors affecting the non-cancer-specific survival (NCSS) in patients with primary central nervous system lymphoma (PCNSL).
This multi-center cohort study included 2497 patients with PCNSL in the Surveillance, Epidemiology and End Results (SEER) database from 2007 to 2016, with a mean follow-up of 4.54 years. The non-cancer-specific death risk in patients with PCNSL and primary central nervous system diffuse large B-cell lymphoma (PCNS-DLBCL) was evaluated using the proportion of deaths, standardized mortality ratio (SMR), and absolute excess risk (AER). Univariate and multivariate competing risk regression models were utilized to identify the risk factors of NCSS.
PCNSL was the most frequent cause of death in PCNSL patients (75.03%). Non-cancer-specific causes constituted a non-negligible portion of death (20.61%). Compared with the general population, PCNSL patients had higher risks of death from cardiovascular disease (CVD) (SMR, 2.55; AER, 77.29), Alzheimer's disease (SMR, 2.71; AER, 8.79), respiratory disease (SMR, 2.12; AER, 15.63), and other non-cancer-specific diseases (SMR, 4.12; AER, 83.12). Male sex, Black race, earlier year of diagnosis (2007-2011), being unmarried, and a lack of chemotherapy were risk factors for NCSS in patients with PCNSL and PCNS-DLBCL (all < 0.05).
Non-cancer-specific causes were important competing causes of death in PCNSL patients. More attention is recommended to non-cancer-specific causes of death in the management of PCNSL patients.
本研究旨在评估原发性中枢神经系统淋巴瘤（PCNSL）患者的非癌症特异性死亡风险，并确定影响非癌症特异性生存（NCSS）的风险因素。
这项多中心队列研究纳入了2007年至2016年监测、流行病学和最终结果（SEER）数据库中的2497例PCNSL患者，平均随访4.54年。采用死亡比例、标准化死亡率（SMR）和绝对超额风险（AER）评估PCNSL和原发性中枢神经系统弥漫性大B细胞淋巴瘤（PCNS-DLBCL）患者的非癌症特异性死亡风险。使用单因素和多因素竞争风险回归模型确定NCSS的风险因素。
PCNSL是PCNSL患者最常见的死亡原因（75.03%）。非癌症特异性原因在死亡中占不可忽视的比例（20.61%）。与一般人群相比，PCNSL患者死于心血管疾病（CVD）（SMR，2.55；AER，77.29）、阿尔茨海默病（SMR，2.71；AER，8.79）、呼吸系统疾病（SMR，2.12；AER，15.63）和其他非癌症特异性疾病（SMR，4.12；AER，83.12）的风险更高。男性、黑人种族、较早的诊断年份（2007 - 2011年）、未婚和未接受化疗是PCNSL和PCNS-DLBCL患者NCSS的风险因素（均P < 0.05）。
非癌症特异性原因是PCNSL患者重要的竞争性死亡原因。在PCNSL患者的管理中，建议更多关注非癌症特异性死亡原因。
