Survival in patients with oral and maxillofacial diffuse large B-cell lymphoma

Abstract

The purpose of this study was to determine the survival and prognostic factors of patients with diffuse large B-cell lymphoma (DL-BCL) of the oral cavity and maxillofacial region. Retrospectively, the clinical records of patients with a primary diagnosis of DLBCL of the oral cavity and maxillofacial region treated at the A.C. Camargo Hospital for Cancer, São Paulo, Brazil, between January 1980 and December 2005 were evaluated to determine (A) overall survival (OS) at 2 and 5 years and the individual survival percentage for each possible prognostic factor by means of the actuarial technique (also known as mortality tables), and the Kaplan Meier product limit method (which provided the survival value curves for each possible prognostic factor); (B) prognostic factors subject to univariate evaluation with the log-rank test (also known as Mantel-Cox), and multivariate analysis with Cox's regression model (all the variables together). The data were considered significant at p ≤ 0.05. From 1980 to 2005, 3513 new cases of lymphomas were treated, of which 151 (4.3%) occurred in the oral cavity and maxillofacial region. Of these 151 lesions, 48 were diffuse large B-cell lymphoma, with 64% for OS at 2 years and 45% for OS at 5 years. Of the variables studied as possible prognostic factors, multivariate analysis found the following variables have statistically significant values: age (p = 0.042), clinical stage (p = 0.007) and performance status (p = 0.031). These data suggest that patients have a higher risk of mortality if they are older, at a later clinical stage, and have a higher performance status.

Clinicopathological analysis of oral diffuse large B‐cell lymphoma, NOS: A systematic review

“…Diffuse large B‐cell lymphoma is clinically and pathologically diverse, consequently, new entities are frequently recognized and subsequently removed from this group, as happened with plasmablastic lymphoma (PBL), EBV‐positive DLBCL NOS and the more recent double‐ and triple‐hit high‐grade lymphomas . Although DLBCL NOS represents the most common lymphoma that can arise in the oral cavity, there is scarce information in the literature regarding its clinical course and prognosis, with only few small series currently available . Therefore, we attempted in this study to systematically review the available data on oral/maxillofacial DLBCL NOS to better determine the clinicopathological features of this neoplasm and of the affected patients.…”

Lymphome non hodgkinien primaire à cellules B larges de la cavité orale : à propos d’un cas clinique

“…D'autres localisations sont très rares notamment la gencive et le périapex. [4,7,9,10]. Pour notre cas, la localisation était palatine.…”

“…C'est le cas de notre patient. Le LNH est caractérisé par sa croissance localisée, cependant le retard du diagnostic peut favoriser sa diffusion [3,4,11]. L'étiologie du LNH n'est pas encore claire [11], plusieurs causes ont été rapporté dans la littérature : L'irradiation, une immunosuppression à long terme, y compris les maladies auto-immunes et la polyarthrite rhumatoïde, le lupus érythémateux systémique, le syndrome de Sjögren, et certaines infections, y compris le virus d'Epstein-Barr (EBV), le virus lymphotrope des cellules T humaines 1 (HTLV-1), le VIH, Helicobacter pylori, Chlamydia, et herpesvirus-8 humain (HHV-8, KSHV) [12,13].…”

“…Si le site est mandibulaire une paresthésie peut être observée [10]. L'aspect radiologique n'est pas spécifique, la lésion est souvent associée à une lyse osseuse dont l'étendue dépend du stade du diagnostic [3,4]. La localisation maxillaire peut être associée à une invasion sinusale.…”

“…Ce sont des cellules lymphoïdes géantes avec de grands noyaux vésiculaires, des nucléoles proéminents et un cytoplasme basophile abondant. L'anatomopathologie permet aussi de déterminer le sous type de la maladie selon la nature de ces cellules [3,4,11,13,14]. Le traitement dépend de plusieurs facteurs : le soustype histologique, le siège, et la taille de la tumeur [3,8,1].…”