Clinical analysis of 49 patients with primary thyroid diffuse large B-cell lymphoma

Abstract

Objective To analyze the clinical characteristics, prognostic factors, and treatment methods for patients with primary thyroid diffuse large B-cell lymphoma(PTDLBCL). Methods The clinical characteristics, treatment methods, and prognosis factors of 49 patients diagnosed as PTDLBCL in Tianjin Medical University Cancer Hospital from January 2000 to December 2014 were retrospectively analyzed. Results The median age of 49 patients was 68(35-86)years, including 20 males and 29 females. According to Ann Arbor stage, there were 15 patients for stage I, 24 for stage II, 4 for stage III, and 6 for stage IV. 15 patients had a history of Hashimoto′s thyroiditis. According to Eastern Collaborative Oncology Group(ECOG), 34 cases were with a performance status score 0-1, and 15 patients were over score 1. According to international prognostic index(IPI), 26 patients were referred to score 0-1(low risk), 14 to score 2(Low-intermediate risk), 4 to score 3(Intermediate-high risk), and 5 to score 4-5(high risk). According to Hans typing, 17 patients were germinal center(GCB)type, 19 patients non-germinal center(Non-GCB), and 13 patients unknown. For the treatment, surgery alone was performed for 13 patients, chemotherapy alone for 6, surgery followed by chemotherapy for 21, and radiotherapy plus chemotherapy for 2, and surgery followed by radiotherapy and chemotherapy for 7 patients. After the median follow-up of 3.46(0.34-15.35)years, 10 patients(52.6%)achieved complete remission(CR)in the surgery/chemotherapy alone group, 25 patients achieved CR in the local treatment plus chemotherapy group(chemotherapy+ radiotherapy, surgery+ chemotherapy, surgery+ radiotherapy+ chemotherapy). The 5-year survival rates of two group were 26.1% and 70.0%, with significant difference(P=0.022). Univariate analysis revealed that lactate dehydrogenase level, ECOG, age, and treatment modality were prognostic factors of survival. Cox multiple factors analysis showed that ECOG was an independent prognostic factor. Conclusion PTDLBCL usually occurs in older patients, with poor prognosis. ECOG is an independent prognostic factor for it. Surgery combined with radiotherapy and chemotherapy may, to some extent, improve the long-term survival. (Chin J Endocrinol Metab, 2016, 32: 830-836) Key words: Diffuse large B-cell lymphoma; Thyroid; Clinical characteristics; Prognosis; Treatment methods