Primary Diffuse Large B-Cell Lymphoma of the Urinary Tract: A Population-Based Analysis

Abstract

ObjectiveDiffuse large B-cell lymphoma (DLBCL) is the most common histopathological type of non-Hodgkin’s lymphoma, which may arise from various extranodal sites. Little is known about the clinical characteristics and survival outcomes of primary DLBCL of the urinary tract (UT). Thus, we conducted this study to explore the independent prognostic factors of patients with UT-DLBCL using the Surveillance, Epidemiology, and End Results (SEER) database.Materials and MethodsWe searched the Surveillance, Epidemiology, and End Results (SEER) database for the data of patients diagnosed with UT-DLBCL between 1975 and 2016. Data, including demographic tumour stage and therapeutic strategies, such as surgical resection, radiation therapy, and chemotherapy, were collected. The impact of these factors on survival outcomes, including overall survival (OS) and disease-specific survival (DSS), was analysed using Kaplan–Meier curves.ResultsFour-hundred and eighty-nine patients who met the inclusion criteria were enrolled in the data analysis. The median age was 69 years old. Most cases of UT-DLBCL (72.39%) originated from the kidney, followed by the urinary bladder (24.95%). Both surgical resection and chemotherapy can significantly improve OS and DSS. Patients older than 75 years had the worst survival outcomes. Stage IV DLBCL may be a poor prognostic factor.ConclusionTo the best of our knowledge, this is the largest population-based study of UT-DLBCL. Advanced age, male gender, lack of surgical resection or chemotherapy, and stage IV DLBCL were poor prognostic factors.

Primary Diffuse Large B-Cell Lymphoma of the Urinary Bladder: Update on a Rare Disease and Potential Diagnostic Pitfalls

“…Although Kempton et al as well as others stated that the most common type of primary UB lymphoma is MALT lymphoma (44.4%) followed by DLBCL in 20% of cases [ 12 , 15 ], in the recent study by Lontos et al, DLBCL was recognized to be the predominant histology comprising 60.3% of primary UB lymphoma, whereas MALT lymphoma was identified in 22.7% of UB lymphoma cases [ 8 ]. The study by Liu et al, evaluating 489 patients with UT-DLBCL diagnosed between 1975 and 2016, is the first study analyzing the clinical features and survival outcomes for UT-DLBCL in a large population [ 14 ]. Liu et al found that the majority of UT-DLBCL originates from the kidney (72.39% of cases), followed by the UB (24.95% of cases) [ 14 ].…”

“…The study by Liu et al, evaluating 489 patients with UT-DLBCL diagnosed between 1975 and 2016, is the first study analyzing the clinical features and survival outcomes for UT-DLBCL in a large population [ 14 ]. Liu et al found that the majority of UT-DLBCL originates from the kidney (72.39% of cases), followed by the UB (24.95% of cases) [ 14 ].…”

“…Most UB-DLBCL (56.56%) are diagnosed as stage 1, compared with only 25.71% of kidney DLBCL cases. Older age represents a poor prognostic factor in UT lymphomas in general [ 8 ], and in UT-DLBCL as well, the mortality of patients over 75 years is 2–3 times higher than that of younger patients [ 14 ], with a 5-year overall survival (OS) of 27.10% for patients over 75 years compared to 64.29% for patients under 60 years.…”

“…Primary urinary tract lymphomas (PUTLs) represent less than 5% of all extranodal NHLs [ 2 , 3 , 4 ]. Primary urinary bladder (UB) lymphoma is a very rare disease, representing less than 0.2% of all extranodal lymphomas and less than 1% of all UB neoplasms [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. Secondary involvement of the UB by systemic lymphoma is a much more common event, being identified in 10–20% of NHLs [ 11 ].…”

“…Most cases of DLBCL of the urinary tract (UT) arise from the kidney (72.39%), followed by the UB (24.95%) [ 1 , 14 ]. Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) has long been considered the most common primary UB lymphoma [ 15 ], until, recently, in a large study on PUTL, DLBCL has been recognized to be the predominant type of primary UB lymphoma [ 8 ].…”