Prognostication of Primary Tumor Location in Early-Stage Nodal Diffuse Large B-Cell Lymphoma: An Analysis of the SEER Database

Abstract

The prognostic role of primary tumor location for clinical outcomes of patients with early-stage nodal diffuse large B-cell lymphoma (DLBCL) remains uncertain. We evaluated the relationship between primary tumor site and overall survival (OS) in 9738 early-stage nodal DLBCL patients from the Surveillance, Epidemiology, and End Results (SEER) database. The primary site of the tumors was characterized as supradiaphragm and subdiaphragm according to the definition of lymph node distribution in the Ann Arbor staging. The OS was significantly better for patients of the supradiaphragm group (n = 6038) compared to the ones from the subdiaphragm group (n = 3655) (hazard ratio (HR) 1.24; 95%CI: 1.16–1.33; P < 0.001), and it was preserved after propensity score matching (PSM) (HR 1.15; 95% CI: 1.07–1.24; P < 0.001). Gene enrichment analyses demonstrated that the subdiaphragm group has an upregulated extracellular matrix (ECM)-related signaling, which reportedly can promote growth, invasion, and metastasis of the cancer, and downregulated interferon response, which is considered to have anti-tumor function. Our results indicate the two tumor locations (supradiaphragm and subdiaphragm) presented different prognostic implications for the overall survival, suggesting that the tumor’s location could serve as a prognostic biomarker for early-stage nodal DLBCL patients.

Development and validation of nomograms by radiomic features on ultrasound imaging for predicting overall survival in patients with primary nodal diffuse large B-cell lymphoma

“…The 5-year survival rate of 145patients in this study was 73.8% (107/145), which was almost the same as the report (74.8%) of Xia et al. ( 32 ), but higher than previous reports (43%-52%) ( 33 ). The reason is that the subjects in this study and Xia et al.…”

5-Hydroxymethylation alterations in cell-free DNA reflect molecular distinctions of diffuse large B cell lymphoma at different primary sites

“…Likewise, PT-DLBCL has a higher tendency to recur, tending to involve the contralateral testis and CNS, with 5-year OS rates of 38.2% to 53.4% [ 4 , 39 ]. However, PG-DLBCL and LN-DLBCL patients face superior clinical outcomes, with 5-year OS rates of 70.3–73% and 59.8–74.8%, respectively [ 4 , 40 , 41 ]. Interestingly, both PI-DLBCL and PG-DLBCL are located in the gastrointestinal tract, but PI-DLBCL patients have a higher tendency of relapse and refractoriness and have a significantly worse prognosis than PG-DLBCL patients, with 5-year OS rates of 56.9–62.4% [ 4 , 42 ].…”