Investigation of epidemiological characteristics and development of a nomogram to predict survival in primary ocular adnexal lymphoma

Abstract

Background: Studies on the epidemiology and prognosis of primary ocular adnexal lymphoma (POAL) are scarce for its low occurrence. The goal of our research was to assess the epidemiologic characteristics, prognostic variables and survival of POAL patients. Methods: The Surveillance, Epidemiology and End Results (SEER) database was used to collect data on patients identified with POAL from 1975 to 2011 and the incidence rate of POAL from 1975 to 2017. To discover independent predictive markers for overall survival (OS) and disease-specific survival (DSS), multivariable Cox regression analysis was utilised. The independent prognostic factors found by multivariate Cox regression analysis were used to generate a nomogram.Results: A total of 2839 patients were diagnosed with POAL, with an average age of 64.1 years. The total incidence of POAL was 2.51/1000000 (according to the overall adjustment of the 2000 American standard) from 1975 to 2017, and the annual percentage change (APC) was 2.47 (95% confidence interval 1.64-3.32, p < 0.05), showing a sharp upward trend. After multivariate Cox regression analysis, age, gender, year of diagnosis, marital status, primary site, laterality, pathological type and treatment strategy were evaluated as independent prognostic factors of OS or DSS (p < 0.05). A nomogram was constructed to forecast the DSS of 1, 3, 5 and 10 years. The concordance index (C-index) and the calibration plots demonstrated the robustness and accuracy of the nomogram.Conclusions: Although POAL is sporadic, the incidence has generally increased in the past 36 years. In recent years, survival rates have risen, and radiotherapy can render better OS and DSS. The nomogram specially made for POAL is robust and precise in predicting the DSS of 1, 3, 5 and 10 years.

Nomograms for Predicting the Overall and Cause-Special Survival of Elderly Patients with Primary Ocular Adnexal Lymphoma

“…POAL represents about 8% of all extranodal lymphomas and is most frequently observed in elderly patients [22][23]. Compared to younger patients, older patients have a signi cantly low survival rate [10]. Additionally, the suitable treatment for young and old POAL patients is not the same [24].…”

“…To our knowledge, there is only one nomogram for POAL patients. Peng et al constructed and validated a POAL-speci c nomogram for CSS and OS [10]. The risk factors included in their models were treatment strategy, pathological type, laterality, primary site, marital status, year of diagnosis, gender, and age.…”

“…Previous studies have proposed prognostic factors of POAL survival, including infectious, genetic, and immune disorders [8][9]. Using age, gender, marital status, treatment modality, pathological type, laterality, primary site, and year of diagnosis, a model for predicting the CSS and OS of POAL patients was constructed by Peng et al [10]. However, populationlevel estimates for the risk factors in elderly patients are lacking.…”

Construction and validation of a novel web-based nomogram for primary ocular adnexal lymphoma: a real-world analysis based on the Surveillance, Epidemiology, and End Results database

“…Non-Hodgkin’s lymphomas are the main pathological type ( 6 - 8 ). Early diagnosis and standardized treatment are important factors affecting the prognosis of POAL ( 9 , 10 ); and conventional treatments for this disease include surgical resection, radiotherapy (RT), and chemotherapy (CT) ( 11 ). Due to the low incidence of this type of tumor, there are fewer reports in the literature on POAL ( 12 - 15 ).…”

Welcoming artificial intelligence into ophthalmology

“…One model in particular, which used raw data derived from the tomography system, had superior discriminating performance in distinguishing eyes with subclinical keratoconus from normal eyes. Peng et al 8 accessed the US Surveillance, Epidemiology and End results database to extract a large clinical dataset derived from 2839 patients with primary ocular adnexal lymphoma. With this dataset, they implemented a nomogram to predict disease‐specific survival at multiple year intervals out to 10 years.…”