Department of Hepatopancreatobiliary Surgery, Qingdao Municipal Hospital, Qingdao University, Qingdao, People's Republic of China.
Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, People's Republic of China.
Ann Surg Oncol. 2023 Nov;30(12):7206-7216. doi: 10.1245/s10434-023-13968-5. Epub 2023 Jul 30.
The purpose of current study was to examine the incidence, characteristics, treatment, and survival of splenic marginal zone lymphoma (SMZL).
Using SEER-18 database, patients diagnosed with SMZL between 2000 and 2018 were included. Effect of splenectomy on survival was evaluated after balancing the confounding factors by propensity score matching. Rates of splenectomy and 1-year relative survival were calculated for each year. A logistic regression model identified factors related to splenectomy, and a Cox regression model assessed factors linked to overall survival (OS).
A total of 2790 patients with SMZL were analyzed. The majority were older than 60 years, female, and white. The age-adjusted incidence of SMZL was 0.17/100,000 person-years, with higher incidence in males. Incidence increased by 0.68%/year and peaked at 80-84 years for both genders. The SMZL-specific survival rates at 3 and 5 years were 89.6% and 85.3%, respectively. Meanwhile, the relative survival rates for the same periods were 88.6% and 85.9%, respectively. Splenectomy patients were more likely to be younger, male, and diagnosed with early-stage disease. Despite the decreasing utilization rate of splenectomy from 59.4% in 2000 to 16.2% in 2018, the 1-year relative survival rate remained relatively stable with minor fluctuations over time. Whether or not the patient underwent splenectomy was not found to be a significant prognostic indicator for OS.
Our study demonstrated a decreasing use of splenectomy but a relatively stable survival in patients with SMZL, highlighting the urgency to better understand the role of splenectomy and its associated outcomes.
本研究旨在探讨脾边缘区淋巴瘤（SMZL）的发病情况、特征、治疗方法和生存率。
本研究使用 SEER-18 数据库，纳入了 2000 年至 2018 年间诊断为 SMZL 的患者。通过倾向评分匹配平衡混杂因素后，评估了脾切除术对生存的影响。计算了每年的脾切除术率和 1 年相对生存率。采用逻辑回归模型确定与脾切除术相关的因素，采用 Cox 回归模型评估与总生存率（OS）相关的因素。
共分析了 2790 例 SMZL 患者。大多数患者年龄大于 60 岁，女性，白人。SMZL 的年龄调整发病率为 0.17/100,000 人年，男性发病率较高。发病率以每年 0.68%的速度增加，男女发病率均在 80-84 岁时达到峰值。3 年和 5 年的 SMZL 特异性生存率分别为 89.6%和 85.3%，同期相对生存率分别为 88.6%和 85.9%。接受脾切除术的患者更年轻、男性，且诊断为早期疾病。尽管脾切除术的使用率从 2000 年的 59.4%下降到 2018 年的 16.2%，但 1 年相对生存率仍保持相对稳定，仅略有波动。患者是否接受脾切除术与 OS 无显著相关性。
本研究表明，SMZL 患者脾切除术的使用率降低，但生存率相对稳定，这突显了迫切需要更好地了解脾切除术的作用及其相关结局。
