Nomogram-Based Prediction of Overall and Cancer-Specific Survival in Patients with Primary Bone Diffuse Large B-Cell Lymphoma: A Population-Based Study

Abstract

Background. Primary bone diffuse large B-cell lymphoma (PD-DLBCL) accounts for more than 80% of primary bone lymphoma. We created two nomograms to predict overall survival (OS) and cancer-specific survival (CSS) in patients with PD-DLBCL for this rare disease. Methods. In total, 891 patients diagnosed with PB-DLBCL between 2007 and 2016 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate Cox analyses were performed to explore independent prognostic factors and create nomograms for OS and CSS. The area under the curve (AUC), the calibration curve, decision curve analysis (DCA), and Kaplan–Meier (K-M) curve analysis were used to evaluate the nomograms. Results. Four variables were identified as independent prognostic factors for OS, and three variables were identified as independent prognostic factors for CSS. The receiver operating characteristic (ROC) curves demonstrated the strong discriminatory power of the nomograms. The calibration and DCA curves showed that the nomograms had a satisfactory ability to predict OS and CSS. The K-M curves showed that age, gender, primary site, chemotherapy, and tumor stage affected patient survival. Conclusions. In patients with PD-DLBCL, age, race, primary site, and chemotherapy affected OS, while age, race, and chemotherapy affected CSS. The two nomograms created based on the aforementioned variables provided more accurate individual survival predictions for PD-DLBCL patients and can help physicians make appropriate clinical decisions.

Primary Bone Lymphoma: A Review of the Literature with Emphasis on Histopathology and Histogenesis

“…PBL is a rare neoplastic disease and accounts for approximately 1% of all lymphomas, 3–7% of extranodal lymphomas and 7% of malignant primary bone tumors [ 4 , 10 , 11 , 12 ]. NHL constitutes the vast majority of PBLs with DLBCL, NOS, representing over 80% of all cases [ 10 , 13 , 14 ]. PBL of T-cell origin is extremely uncommon, but has a higher relative frequency in Japan and Taiwan compared to the West [ 15 , 16 ].…”

“…PBL of T-cell origin is extremely uncommon, but has a higher relative frequency in Japan and Taiwan compared to the West [ 15 , 16 ]. PBL may occur at all ages, with a typical diagnosis age of 45–60 years [ 10 , 15 , 17 ]. In addition, men are affected more than women, with a male/female ratio of 1.2–1.8 [ 3 ].…”

“…PBL can develop in any part of the skeleton, although is most common in the femur, humerus, tibia, spine and pelvis [ 2 , 3 , 4 , 7 , 8 , 9 , 10 , 17 , 20 , 21 , 22 , 24 , 31 ]. Other less common sites of occurrence include the skull, forearm, scapula, clavicle, patella, hands and feet [ 3 , 4 , 9 , 10 , 17 , 21 , 25 ].…”

“…PBL can develop in any part of the skeleton, although is most common in the femur, humerus, tibia, spine and pelvis [ 2 , 3 , 4 , 7 , 8 , 9 , 10 , 17 , 20 , 21 , 22 , 24 , 31 ]. Other less common sites of occurrence include the skull, forearm, scapula, clavicle, patella, hands and feet [ 3 , 4 , 9 , 10 , 17 , 21 , 25 ]. Interestingly, younger age has been associated with an appendicular location of PBL, which could be explained by the active bone marrow present in the long bones of younger patients [ 24 ].…”

“…Therefore, there is no standard treatment for this condition and the recommended strategies are derived from retrospective studies. Treatment options include chemotherapy or immunochemotherapy, radiotherapy and surgery [ 2 , 10 ]. Pain management in patients with bone tumors is of great significance.…”