Prognostic Factors Associated with Bone Lymphoma Primarily Presenting in the Spine

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Abstract

Study Design.

Retrospective analysis.

Objective.

To determine the prognostic indicators in patients with bone lymphoma of the spine

Summary of Background Data.

To date, prognosis for patients with spinal bone lymphoma is based on results from small series. Large population-based observational studies are lacking.

Methods.

The Surveillance, Epidemiology, and End Results (SEER) Registry was used to identify all patients with bone lymphoma of the spine from 1995 through 2014. Overall survival (OS) and disease-specific survival (DSS) estimates were obtained using the Kaplan-Meier method and compared across groups using log-rank test. Association of survival with variables was assessed using Cox proportional-hazards regression analysis. Nomograms were established and validated by R software.

Results.

A total of 1338 patients were identified with bone lymphoma of the spine. The trend of incidence was relative steady from 1995 to 2014. The mean and median age of diagnosis was 62.9 and 66.0 years, respectively. Men constituted a slightly greater proportion (55.5%) of the cohort. The most common subtype of lymphoma was diffuse large B-cell lymphoma (59.8%). The 5-year and 10-year OS rates for those patients were 60.6% and 44.7%, respectively. Multivariate analysis revealed that age, sex, marital status and race were sociodemographic predictors of OS and DSS. Extra-compartmental invasion of tumor and Stage IV of lymphoma were significantly corelated with poor OS and DSS. Patients without surgery nor radiotherapy was linked to a poor OS. Both OS and DSS of patients with spinal bone lymphoma improved in 2005 to 2014 when compared to 1995 to 2004. In addition, pre-treatment nomograms to predict 5-year and 10-year survival were established.

Conclusions.

The findings of this study provide population-based estimates of the prognosis for patients with spinal bone lymphoma. Both sociodemographic and clinical factors may have an impact on the outcomes.

Conclusions.

Level of Evidence: 4.

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