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

Abstract

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.

Cardiovascular Outcomes in the Patients With Colorectal Cancer: A Multi-Registry-Based Cohort Study of 197,699 Cases in the Real World

“…Furthermore, we should be aware that high discrimination calibration does not necessarily imply an excellent clinical utility. Hence, DCA was employed to determine the clinical utility of this nomogram by calculating the net benefits at each risk threshold probability ( 23 , 24 ). Results showed that using the nomogram to predict the probabilities of CVD provided more benefits.…”

“…Generally speaking, the SEER database, accounting for about a third of the United States population, provides large enough sample data to explore risk factors and further develop a nomogram based on competing risk analysis. More to the point, results from analyses that use population-level databases tend to be more generalizable and representative than those from single-center reports ( 24 ). Actually, sufficient incorporated samples are needed to guarantee the accuracy of nomograms, as demonstrated our recent publications ( 5 , 18 , 24 ).…”

“…We used the concordance index (C-index) to measure discriminative performance of the model, and the consistency was measured using a calibration curve ( 18 ). Decision curve analysis (DCA) was performed to visually investigate the clinical utilities and net benefits of this model ( 23 , 24 ). The packages cmprsk , survival , mstate , rm s, pec , and riskRegression in the R software (version 3.2.5) were used to establish and validate the nomogram.…”

Clinical management and susceptibility of primary hepatic lymphoma: A cases-based retrospective study

“…However, some questions, including treatment choice or susceptibility of immunoincompetent patients, remain disputable in the rituximab era. A large population-level study conducted using the SEER database concluded that the incidence of PHL has been steadily increasing[ 2 , 7 ], but failed to more practically elucidate PHL. Due to the lack of large-scale clinical trials, PHL patients are treated empirically.…”

Hepatic Reactive Lymphoid Hyperplasia and Primary Hepatic Lymphoma: Ultrasound Features and Differentiation Diagnosis

“…PHL is a kind of extranodal malignant lymphoma, only localized in the liver without involvement of distant lymph nodes, spleen, bone marrow, other lymphoid tissues and organs. It is characterized by monoclonal lymphocyte proliferation, cell atypia and mitosis [4][5][6]. PHL is also an infrequent focal lesion of the liver, accounting for only 0.1% of liver malignant tumors [7].…”