Department of Hematology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Nursing department, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Medicine (Baltimore). 2024 Feb 23;103(8):e37238. doi: 10.1097/MD.0000000000037238.
The goal of this study was to investigate the clinical characteristics, prognostic variables, and survival of patients with primary mediastinal diffuse large B cell lymphoma (PMBCL) in the rituximab era. The Surveillance, Epidemiology, and End Results (SEER) database was used to identify PMBCL patients diagnosed between 2000 and 2019. The Kaplan-Meier (K-M) technique and log-rank test were used to assess overall survival (OS) and disease-specific survival (DSS). The independent prognostic variables for OS and DSS were identified using univariate and multivariate Cox regression analysis. Nomograms were created to predict survival prospects according to identified prognostic indicators. Totally, 841 patients were enrolled with PMBCL. One-year, 5-year, and 10-year OS rates were 93.99%, 85.04%, and 81.76%, and the corresponding DSS rates were 95.27%, 87.37%, and 85.98%. The results of multivariate Cox regression analysis demonstrated that age, years of diagnosis, Ann arbor staging, and chemotherapy were independent prognostic factors for survival. Nomograms designed exclusively for PMBCL were created to forecast the likelihood of 1-year, 5-year, and 10-year OS and DSS, respectively. The Harrell concordance index (C-index) for the nomograms predictions of OS and DSS were 0.704 and 0.733, respectively, which showed the established model harboring powerful and accurate performance. The present study revealed that incidence of PMBCL has been consistently rising over the last 20 years. Simultaneously, survival rates have improved tremendously. Rituximab based immunochemotherapy has emerged as an effective treatment option, leading to enhanced OS and DSS outcomes. Furthermore, the nomograms specifically developed for PMBCL have demonstrated robustness and accuracy in forecasting OS and DSS rates at 1, 5, and 10 years. These predictive tools can be valuable for clinicians in accurately estimating prognosis and establishing personalized treatment plans and follow-up protocols.
这项研究的目的是调查利妥昔单抗时代原发性纵隔弥漫性大 B 细胞淋巴瘤（PMBCL）患者的临床特征、预后变量和生存情况。我们使用监测、流行病学和最终结果（SEER）数据库来确定 2000 年至 2019 年间诊断为 PMBCL 的患者。我们使用 Kaplan-Meier（K-M）技术和对数秩检验来评估总生存率（OS）和疾病特异性生存率（DSS）。我们使用单因素和多因素 Cox 回归分析确定 OS 和 DSS 的独立预后因素。根据确定的预后指标创建列线图来预测生存前景。总共纳入了 841 例 PMBCL 患者。1 年、5 年和 10 年 OS 率分别为 93.99%、85.04%和 81.76%，相应的 DSS 率分别为 95.27%、87.37%和 85.98%。多因素 Cox 回归分析的结果表明，年龄、诊断年限、Ann arbor 分期和化疗是生存的独立预后因素。专门为 PMBCL 设计的列线图分别用于预测 1 年、5 年和 10 年的 OS 和 DSS。OS 和 DSS 预测的 Harrell 一致性指数（C-index）分别为 0.704 和 0.733，表明建立的模型具有强大而准确的性能。本研究表明，过去 20 年来，PMBCL 的发病率一直在持续上升。同时，生存率也有了显著提高。利妥昔单抗为基础的免疫化疗已成为一种有效的治疗选择，导致 OS 和 DSS 结果的改善。此外，专门为 PMBCL 开发的列线图在预测 1、5 和 10 年的 OS 和 DSS 率方面表现出稳健性和准确性。这些预测工具对于临床医生准确估计预后、制定个性化治疗计划和随访方案具有重要价值。
