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. 2022 Jul 6:9:829048.
doi: 10.3389/fsurg.2022.829048. eCollection 2022.

Primary Brainstem Lymphoma: A Population-Based Study

Junyu Chen  1 , Bo Cen  1 , Fei Hu  1 , Yong Qiu  1 , Guomin Xiao  1 , Junge Zhou  1 , Xiujian Ma  2 , Fangcheng Zhang  3
Affiliations

Primary Brainstem Lymphoma: A Population-Based Study

Junyu Chen et al. Front Surg. .

Abstract

Background: Primary brainstem lymphoma (PBSL) is rare and malignant. An understanding of this disease is lacking. We aimed to characterize clinical features, estimate survival, and explore survival-related factors of PBSL.

Methods: Patients with a histological diagnosis of primary lymphoma in the brainstem (C71.7) from 1975 to 2016 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) program. Log-rank tests and univariate and multivariate Cox proportional hazard analyses were used to identify survival-related factors.

Results: PBSL constituted 2.7% of brainstem malignancies. The median age of the PBSL patients was 59.5 years. Diffuse large B cell lymphoma (n = 49, 84.5%) was the most prevalent histology among the 58 cases with reported specific lymphoma subtype. The majority of PBSLs were localized (n = 46, 52.3%), at low Ann Arbor Stage (I/II, n = 63, 70.5%), and presented as a single primary (n = 71, 80.7%). Chemotherapy was applied in 50 (56.8%) cases. Three-year overall survival (OS) and disease-specific survival (DSS) rates were 42.7% and 53.5%, respectively. Multivariate analyses showed that independent predictive/prognostic factors for OS were age (P = 0.004), tumor number (P = 0.029), and chemotherapy (P = 0.001); DSS-related factors only included age (P = 0.014) and chemotherapy (P = 0.008).

Conclusions: We estimated survival rates for PBSL patients. Factors associated with OS and DSS were also identified. Our findings addressed the importance of chemotherapy in treating PBSL patients.

Keywords: SEER; chemotherapy; primary brainstem lymphoma; surgery; survival.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A) Flow diagram of study cohort selection. (B) Histological variants of primary brainstem lymphoma (PBSL). ALK, anaplastic lymphoma kinase; DLBCL, diffuse large B cell lymphoma; NOS, not otherwise specified.
Figure 2
Figure 2
Kaplan–Meier overall survival curves of PBSL patients stratified by diagnosis year (A), age at diagnosis (B), tumor number (C), and use of chemotherapy (D).
Figure 3
Figure 3
Forest plot based on univariate and multivariate Cox proportional hazard analysis of overall survival (OS) for PBSL patients. GTR, gross total resection; OS, overall survival; PR, partial resection. *, P < 0.05; **, P < 0.01; ***, P < 0.001.
See this image and copyright information in PMC

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