Department of Dermatology and Venereology, Peking University First Hospital, Beijing, China.
Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China.
JAMA Dermatol. 2023 Oct 1;159(10):1059-1067. doi: 10.1001/jamadermatol.2023.2634.
There are limited prognostic statistics and data available on survival outcomes for patients with mycosis fungoides (MF) in Asia.
To determine the prognostic factors and survival outcomes of patients with MF among a cohort in China.
DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective cohort study of patients with MF who received treatment at a tertiary referral center for skin lymphoma (Peking University First Hospital, Beijing, China) from August 1, 2009, to August 31, 2021. Data were analyzed from September 1, 2021, to December 31, 2022.
Overall survival (OS), disease-specific survival (DSS), and progression-free survival (PFS); for prognostic factors, hazard ratios (HRs), and adjusted HRs (aHRs; adjusted for sex, age, and overall TNMB [tumor, node, metastasis, blood] stage) determined using the Cox proportional hazards model.
The study cohort comprised 461 patients with MF (median [range] age at diagnosis, 46 [5-87] years; 275 [59.7%] men and 186 [40.3%] women; 461 [100%] Chinese). The overall 5-year rate was 82.2% for OS, 83.5% for DSS, and 79.6% for PFS. Stage-specific 5-year OS rates were 95.7% for stage IA, 93.2% for IB, 95.7% for IIA, 70.1% for IIB, 55.3% for III, and 23.6% for IV. Compared with a UK cohort, our Chinese cohort had a younger median age at diagnosis (46 years vs 54 years) and a more favorable 5-year OS (82.2% vs 75.0%); however, after adjusting for age, the discrepancy in the 5-year OS rate was diminished (77.3% vs 76.4%). Cox models revealed that unfavorable predictors of OS, PFS, and DSS, respectively, were: age older than 60 years (aHR [95% CI], 2.25 [1.28-3.96]; 2.09 [1.16-3.76]; 2.27 [1.39-3.72]); advanced TNMB stage; advanced overall stage; large-cell transformation (aHR [95% CI], 2.16 [1.17-3.99]; 2.29 [1.21-4.33]; 2.21 [1.26-3.86]); and elevated lactate dehydrogenase levels (aHR [95% CI], 3.92 [1.64-9.36]; 4.77 [1.86-12.22]; 5.05 [2.23-11.42]). Biological sex and plaque lesion type were not associated with prognosis among this study cohort.
The findings of this retrospective cohort study of patients with MF in China suggest that Asian patients are diagnosed at a younger age and have a higher 5-year OS compared with patients of other races in studies in other countries (predominantly White). Prognostic factors were similar to those of previous studies, except for patient sex and plaque lesion type.
亚洲患有蕈样真菌病（MF）的患者的生存结果预后统计数据和资料有限。
确定中国队列中 MF 患者的预后因素和生存结果。
设计、地点和参与者：这是一项回顾性队列研究，纳入了 2009 年 8 月 1 日至 2021 年 8 月 31 日在北京北京大学第一医院接受皮肤淋巴瘤治疗的 MF 患者。数据分析于 2021 年 9 月 1 日至 2022 年 12 月 31 日进行。
总生存（OS）、疾病特异性生存（DSS）和无进展生存（PFS）；对于预后因素，使用 Cox 比例风险模型确定危险比（HR）和调整后的 HR（aHR；调整性别、年龄和整体 TNMB [肿瘤、淋巴结、转移、血液] 分期）。
研究队列包括 461 名 MF 患者（中位[范围]诊断时年龄，46[5-87]岁；275[59.7%]男性和 186[40.3%]女性；461[100%]中国人）。5 年 OS 率总体为 82.2%，DSS 率为 83.5%，PFS 率为 79.6%。特定于阶段的 5 年 OS 率分别为 IA 期 95.7%、IB 期 93.2%、IIA 期 95.7%、IIB 期 70.1%、III 期 55.3%和 IV 期 23.6%。与英国队列相比，我们的中国队列的中位诊断年龄更年轻（46 岁 vs 54 岁），5 年 OS 率更高（82.2% vs 75.0%）；然而，在调整年龄后，5 年 OS 率的差异减小（77.3% vs 76.4%）。Cox 模型显示，OS、PFS 和 DSS 的不利预测因素分别为：年龄大于 60 岁（aHR [95%CI]，2.25 [1.28-3.96]；2.09 [1.16-3.76]；2.27 [1.39-3.72]）；晚期 TNMB 分期；晚期总体分期；大细胞转化（aHR [95%CI]，2.16 [1.17-3.99]；2.29 [1.21-4.33]；2.21 [1.26-3.86]）；和乳酸脱氢酶水平升高（aHR [95%CI]，3.92 [1.64-9.36]；4.77 [1.86-12.22]；5.05 [2.23-11.42]）。在该研究队列中，生物学性别和斑块病变类型与预后无关。
这项对中国 MF 患者的回顾性队列研究表明，与其他国家（主要是白人）研究中的患者相比，亚洲患者的诊断年龄更小，5 年 OS 率更高。预后因素与以往研究相似，除了患者性别和斑块病变类型。
