Surgical Resection for Primary Central Nervous System Lymphoma: A Systematic Review

Labak, Collin M.; Holdhoff, Matthias; Bettegowda, Chetan; Gallia, Gary L.; Lim, Michael; Weingart, Jon; Mukherjee, Debraj

doi:10.1016/j.wneu.2019.02.252

Cited by 35 publications

(23 citation statements)

References 32 publications

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“…The patients with PCNS-DLBCL, comparing with the largest descriptive research of China, had a better outcome in our center. Studies have shown that surgical excision for intracranial PCNS-DLBCL does not improve survival [29,30], and our results are consistent. Systemic chemotherapy combined with intravitreal chemotherapeutic drug injection for patients with primary vitreoretinal DLBCL(PVR-DLBCL) as initial treatment may achieve a relatively better outcome [20].…”

Section: Discussionsupporting

confidence: 87%

Primary Extranodal Diffuse Large B-Cell Lymphoma In The Rituximab Era: A Single Center, Retrospective Analysis

Zhao

Zhou

Zhang

et al. 2022

Preprint

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Background: A large proportion of diffuse large B-cell lymphoma originates from extranodal sites. The outcomes of Chinese patients with primary extranodal diffuse large B-cell lymphoma (PE-DLBCL) have been greatly improved. Methods: Clinical features and outcomes of 197 patients newly diagnosed with PE-DLBCL from January 2015 to December 2020 were analyzed retrospectively. Results: (1) Gastrointestinal tract (34%) involvement ranked first, followed by central nervous system (CNS) and intraocular (31.5%), nose/nasopharynx (7.1%), breast (5.1%), testis (3.6%) and others. (2) The 3-year overall survival (OS) rate for the entire group was 81%; The 3-year OS rate of PE-DLBCL with CNS and vitreoretinal involvement was 79%. (3) In univariate analysis of PE-DLBCL, Ann Arbor stage, evaluated LDH, IPI>2 and complete remission (CR) were significantly related to survival. The lack of CR was the only independent adverse prognostic factor in OS (p = 0.000; HR = 4.659). (4) Lugano stage and treatment response were independent prognostic factors for primary gastrointestinal DLBCL. Conclusion: This is a single-center report of PE-DLBCL in China in the past 5 years with a fairly excellent outcome and a large scale. The treatment response of patients is significantly better than before, especially in patients with CNS and vitreoretinal involvement.

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Section: Discussionsupporting

confidence: 87%

Primary Extranodal Diffuse Large B-Cell Lymphoma In The Rituximab Era: A Single Center, Retrospective Analysis

Zhao

Zhou

Zhang

et al. 2022

Preprint

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“…However, with a large number of applications of new techniques and practices in recent years, including increased use of MRI, frameless stereotyping, and tumor visualization, effectiveness and tolerability have greatly improved. Survival advantage was proven and the traditional view has been questioned in some studies (27)(28)(29). This study showed that surgical resection might play a role in significantly improving OS and DSS and was an independent risk factor for survival.…”

Section: Discussionmentioning

confidence: 82%

Epidemiologic Characteristics, Prognostic Factors, and Treatment Outcomes in Primary Central Nervous System Lymphoma: A SEER-Based Study

et al. 2022

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ObjectiveThis study was conducted in order to study the clinical characteristics, prognostic factors, and treatment outcomes in patients with primary central nervous system lymphoma (PCNSL).Materials and MethodsThe data of a total of 5,166 PCNSL patients diagnosed between 2000 and 2018 from the Surveillance, Epidemiology, and End Results (SEER) database were obtained.ResultsThe mean age was 63.1 ± 14.9 years, with a male to female ratio of 1.1:1.0. The most common histologic subtype was diffuse large B-cell lymphoma (DLBCL) (84.6%). The 1-, 3-, and 5-year overall survival (OS) rates were 50.1%, 36.0%, and 27.2%, respectively, and the corresponding disease-specific survival (DSS) rates were 54.4%, 41.3%, and 33.5%, respectively. Multivariate analysis with Cox regression showed that race, sex, age, marital status, surgical resection, and chemotherapy were independent prognostic factors for OS and DSS, but radiotherapy was only for OS. Nomograms specially for DLBCL were established to predict the possibility of OS and DSS. The concordance index (C-index) values of OS and DSS were 0.704 (95% CI 0.687–0.721) and 0.698 (95% CI 0.679–0.717), suggesting the high discrimination ability of the nomograms.ConclusionSurgical resection and/or chemotherapy was favorably associated with better OS and DSS. However, radiotherapy was not beneficial for OS and DSS in the long term. A new predictive nomogram and a web-based survival rate calculator we developed showed favorable applicability and accuracy to predict the long-term OS for DLBCL patients specifically.

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“…However, with the large number of applications of new techniques and practices in recent years, including increased use of MRI, frameless stereotyping and tumor visualization, the effectiveness and tolerability have greatly improved. Survival advantage was proven and the traditional view has been questioned in some studies [19][20][21]. Therefore, the role of surgery in PCNSL should be reevaluated.…”

Section: Discussionmentioning

confidence: 99%

Epidemiologic Characteristics, Prognostic Factors and Treatment Outcomes in Primary Central Nervous System Lymphoma: A SEER-Based Study

Dongsheng¹,

Chen²,

Shi³

et al. 2021

Preprint

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Objective: To study the clinical characteristics, prognostic factors and treatment outcomes in patients with primary central nervous system lymphoma (PCNSL).Materials and Methods: The data of total 5166 PCNSL patients diagnosed between 2000 and 2018 from the Surveillance, Epidemiology, and End Results (SEER) database was obtained.Results: The mean age was 63.1±14.9 years, with a male to female of 1.1:1.0. The most common histologic subtype was diffuse large B-cell lymphoma (DLBCL) (84.6%). The 1-, 3-, and 5-year OS were 50.1, 36.0 and 27.2% and corresponding to DSS were 54.4, 41.3 and 33.5%, respectively. Multivariate analysis with Cox regression showed that race, sex, age, marital status, surgery, chemotherapy and radiotherapy were independent prognostic factors for OS, but radiotherapy no longer for DSS. Nomograms specially for DLBCL were established to predict the possibility of OS and DSS. The concordance index (C-index) of OS and DSS were 0.704 (95% CI 0.687-0.721) and 0.698 (95% CI 0.679-0.717), suggesting the high discrimination ability of the nomograms.Conclusion: Surgery or/and chemotherapy was favourably associated with better OS and DSS. However, radiotherapy did not benefit to OS and DSS in the long-term. A new predictive nomogram and a web-based survival rate calculator we developed showed favorable applicability and accuracy to predict the long-term OS for DLBCL patients specifically.

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Surgical Resection for Primary Central Nervous System Lymphoma: A Systematic Review

Cited by 35 publications

References 32 publications

Primary Extranodal Diffuse Large B-Cell Lymphoma In The Rituximab Era: A Single Center, Retrospective Analysis

Primary Extranodal Diffuse Large B-Cell Lymphoma In The Rituximab Era: A Single Center, Retrospective Analysis

Epidemiologic Characteristics, Prognostic Factors, and Treatment Outcomes in Primary Central Nervous System Lymphoma: A SEER-Based Study

Epidemiologic Characteristics, Prognostic Factors and Treatment Outcomes in Primary Central Nervous System Lymphoma: A SEER-Based Study

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