Incidence, Prognostic Factors and Survival Outcome in Patients With Primary Hepatic Lymphoma

Shi-Long Zhang; Chen Chen; Qian-Wen Rao; Zhe Guo; Xin Wang; Zhi-Ming Wang; Li-Shun Wang

doi:10.3389/fonc.2020.00750

Incidence, Prognostic Factors and Survival Outcome in Patients With Primary Hepatic Lymphoma

Front Oncol. 2020 May 14:10:750. doi: 10.3389/fonc.2020.00750. eCollection 2020.

Authors

Shi-Long Zhang¹, Chen Chen², Qian-Wen Rao¹, Zhe Guo³, Xin Wang⁴, Zhi-Ming Wang^{5

6}, Li-Shun Wang¹

Affiliations

¹ Minhang Hospital, Fudan University, Shanghai, China.
² Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, China.
³ Department of Internal Medicine, Ophthalmic Hospital of Hebei Province, Xingtai, China.
⁴ Department of Acupuncture and Moxibustion, Central Hospital of Shanghai Xuhui District, Shanghai, China.
⁵ Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, China.
⁶ Department of Medical Oncology, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China.

Abstract

Aim: The objective of our study was to investigate the epidemiologic characteristics, prognostic factors and survival in patients with primary hepatic lymphoma (PHL). Methods: PHL patients diagnosed between 1983 and 2015 were identified from the SEER database. The temporal trend in PHL incidence was assessed using joinpoint regression software. Overall survival(OS) and disease-specific survival (DSS) was evaluated using the Kaplan-Meier method and log-rank test. Univariate and multivariate Cox regression analysis was performed to identify the independent prognostic factors for OS and DSS. Nomograms to predict survival possibilities were constructed based on the identified independent prognostic factors. Results: A total of 1,182 patients were identified with PHL. The mean age was 61.7 ± 17.1 years with a male to female of 1.6:1. Diffuse large B-cell lymphoma (59.8%) was the most common histological subtype. The incidence of PHL steadily increasing by an annual percentage change (APC) of 2.6% (95% CI 2.0-3.2, P < 0.05). The 1-, 5-, and 10-year OS rates were 50.85, 39.6, and 30.4%, respectively, and the corresponding DSS rates were 55.3, 47.9, and 43.3%, respectively. Multivariate Cox regression analysis revealed that age, sex, race, marital status, histological subtype, surgery, and chemotherapy were independent prognostic factors for survival. Nomograms specifically for DLBCL were constructed to predict 1-, 5-, and 10-year OS and DSS possibility, respectively. The concordance index (C-index) and calibration plots showed the established nomograms had robust and accurate performance. Conclusion: PHL were rare but the incidence has been steadily increasing over the past four decades. Survival has improved in recent years. Surgery or chemotherapy could provide better OS and DSS. The established nomograms specifically for DLBCL were robust and accurate in predicting 1-, 5-, and 10-year OS and DSS.

Keywords: SEER; incidence; nomogram; primary hepatic lymphoma; prognosis; treatment.