Nanchang University, 461 Bayi Avenue, Nanchang, 330006, Jiangxi, China.
Jinggangshan University, Ji'an, 3343000, China.
Ann Hematol. 2023 Jul;102(7):1857-1865. doi: 10.1007/s00277-023-05171-z. Epub 2023 May 15.
Primary splenic diffuse large B cell lymphoma (DLBCL) is one of the most common primary tumors in the spleen, while its prevalence is relatively low. Recently, there has been an increase in the incidence rate of primary splenic DLBCL; however, the effectiveness of various treatments for it has not been adequately described previously. The purpose of this study was to compare the effectiveness of various treatments on survival time in primary splenic DLBCL. A total of 347 patients with primary splenic DLBCL were enrolled in The Surveillance, Epidemiology, and End Results (SEER) database. These patients were subsequently divided into four subgroups according to the treatment modalities: non-treatment group (patients who had not received chemotherapy, radiotherapy, or splenectomy, n=19), splenectomy group (patients who had received splenectomy only, n=71), chemotherapy group (patients who had received chemotherapy only, n=95), and the splenectomy combined with chemotherapy group (patients who had received splenectomy and chemotherapy, n=162). The overall survival (OS) and cancer specific survival (CSS) of four treatment groups were evaluated. Compared to the splenectomy group and the non-treatment group, the OS and CSS of the splenectomy combined with chemotherapy group was extremely significantly prolonged (P<0.01). Compared with the chemotherapy group, the OS and CSS of the splenectomy combined with chemotherapy group were longer, but there was no statistical difference (P>0.05). The Cox regression analysis showed that the treatment modality was identified as an independent prognostic factor for primary splenic DLBCL. The landmark analysis shows that the overall cumulative mortality risk was significantly lower in the splenectomy combined with chemotherapy group than in the chemotherapy group within 30 months (P<0.05), and the cancer-specific mortality risk was significantly lower in the splenectomy combined with chemotherapy group than in the chemotherapy group within 19 months (P<0.05). Splenectomy combined with chemotherapy may be the most effective treatment modality for primary splenic DLBCL.
原发性脾脏弥漫性大 B 细胞淋巴瘤（DLBCL）是脾脏最常见的原发性肿瘤之一，但其患病率相对较低。最近，原发性脾脏 DLBCL 的发病率有所增加；然而，之前并没有充分描述过各种治疗方法对其的疗效。本研究旨在比较不同治疗方法对原发性脾脏 DLBCL 患者生存时间的影响。共有 347 例原发性脾脏 DLBCL 患者纳入监测、流行病学和最终结果（SEER）数据库。根据治疗方式，这些患者随后被分为四组：非治疗组（未接受化疗、放疗或脾切除术的患者，n=19）、脾切除术组（仅接受脾切除术的患者，n=71）、化疗组（仅接受化疗的患者，n=95）和脾切除术联合化疗组（接受脾切除术和化疗的患者，n=162）。评估了四组治疗的总生存（OS）和癌症特异性生存（CSS）。与脾切除术组和非治疗组相比，脾切除术联合化疗组的 OS 和 CSS 显著延长（P<0.01）。与化疗组相比，脾切除术联合化疗组的 OS 和 CSS 更长，但无统计学差异（P>0.05）。Cox 回归分析显示，治疗方式是原发性脾脏 DLBCL 的独立预后因素。里程碑分析显示，脾切除术联合化疗组的总累积死亡率在 30 个月内明显低于化疗组（P<0.05），脾切除术联合化疗组的癌症特异性死亡率在 19 个月内明显低于化疗组（P<0.05）。脾切除术联合化疗可能是治疗原发性脾脏 DLBCL 最有效的方法。
