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. 2018 Oct 10:10:4411-4419.
doi: 10.2147/CMAR.S155170. eCollection 2018.

Clinicopathological characteristics and prognostic factors for primary thyroid lymphoma: report on 28 Chinese patients and results of a population-based study

Endong Chen  1 , Qiaolin Wu  2 , Yixiang Jin  1 , Wenxu Jin  1 , Yefeng Cai  1 , Qingxuan Wang  1 , Xiaohua Zhang  1 , Ouchen Wang  1 , Quan Li  1 , Zhouci Zheng  3
Affiliations

Clinicopathological characteristics and prognostic factors for primary thyroid lymphoma: report on 28 Chinese patients and results of a population-based study

Endong Chen et al. Cancer Manag Res. .

Abstract

Objectives: Few studies on prognostic indicators for primary thyroid lymphoma (PTL) have been presented due to the uncommon nature of the tumor. This is the first study to explore the independent prognostic factors in the 2 PTL subtypes.

Methods: We retrospectively reviewed 1,653 cases of PTL. The cases comprised 28 Chinese patients from a local cohort and 1,625 patients from the Surveillance, Epidemiology, and End Results database from 1973 to 2013. Statistical analysis was performed to determine the demographics and prognostic factors of PTL patients.

Results: The disease-specific survival (DSS) and prognostic indicators were significantly different between patients with extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) and patients with diffuse large B-cell lymphoma (DLBCL). Patients with MALT lymphoma were younger (P=0.011) and had lower clinical stage (P=0.014) compared to patients with DLBCL. Cox regression analysis revealed that age, treatment modalities employed, clinical stage, and number of other types of cancer were independent prognostic factors for DLBCL patients.

Conclusion: PTL demonstrates specific clinical features and is associated with a relatively good prognosis. Older age is associated with poor DSS in both MALT patients and DLBCL patients. Additionally, combination of different treatment modalities is associated with improved DSS in DLBCL patients.

Keywords: SEER database; combined modality treatment; disease-specific survival; primary thyroid lymphoma; prognosis.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Relationship between DSS rate and clinicopathological features among different PTL subtypes. Note: (A) Patients with MALT have better DSS compared with patients with DLBCL. (B) Older age (P=0.006) could significantly shorten the DSS of patients with MALT. (C–G) Lower DSS rate was associated with older age (P<0.001), clinical stage of IV (P=0.009), unmarried status (P<0.001), residence in a northern region (P=0.031), and presence of a single lymphoma (P<0.05) in patients with DLBCL. (H) Surgery alone (P=0.018) or combined surgery and radiotherapy (P=0.006) could markedly improve the DSS rate of DLBCL patients. (I) Aggressive surgical treatments, including thyroid lobectomy (P=0.014) and near-total/total thyroidectomy (P=0.019), could significantly prolong the DSS of DLBCL patients. Abbreviations: DLBCL, diffuse large B-cell lymphoma; DSS, disease-specific survival; MALT, extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue; PTL, primary thyroid lymphoma.
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