Diagnostic Interval in Extranodal Non-Hodgkin Head and Neck Lymphomas.

Alba Bello Castro,Javier Seoane Romero,Francisco Gude Sampedro,Máximo Francisco Fraga Rodríguez,Benjamín Martin-Biedma,Juan Seoane,Pablo Castelo-Baz

doi:10.3390/jcm11030853

Alba Bello Castro, Javier Seoane Romero + Show 5 more

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https://doi.org/10.3390/jcm11030853

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Abstract

The aim of this study is to measure the diagnostic interval (DI) of primary extranodal non-Hodgkin lymphomas (PE-NHL) affecting the head and neck and to discover any associated factors. With this aim, we performed a retrospective observational study in northwestern Spain on patients diagnosed between 1 January 2005 and 1 January 2016. A search was made across the electronic health records of the public health system of this region (SERGAS). DI was used as the dependent variable, and different clinicopathological data of the corresponding patients and tumors were analyzed as exposure variables. PE-NHLs were mostly located in Waldeyer’s ring, and they presented a B phenotype and had a median DI of 65 days. Shorter diagnostic intervals were observed in (1) PE-NHL patients who had comorbidities (p = 0.02), (2) PE-NHL that caused symptoms of dysphagia (p = 0.04), (3) tumors with the highest proliferative activity (Ki67 > 80%) (p = 0.04), and (4) tumors diagnosed in the advanced stages of the disease (p = 0.004). Univariate analysis revealed a significant association between dysphagia and a shorter DI. We conclude that raising awareness about these neoplasms and warning about the presenting symptoms can contribute to earlier diagnoses of these tumors and to better outcomes.

Highlights

Lymphomas are solid tumors of the immune system, and among these, non-Hodgkin lymphomas (NHLs) account for 90% of the total
Considering this lack of studies, our objectives were to measure the diagnostic interval in primary extranodal non-Hodgkin lymphomas (PE-NHL) of the head and neck and to analyze the clinical and pathological variables associated with this time interval
A total of 139 patients diagnosed with symptomatic PE-NHL met the inclusion criteria in the study with a male/female ratio of 1.01 and a mean age of 67.5 ± 16.8 years

Summary

Introduction

Lymphomas are solid tumors of the immune system, and among these, non-Hodgkin lymphomas (NHLs) account for 90% of the total. Diagnostic and therapeutic delays are associated with an increase in complications, and in particular, such delays are independent prognostic factors in aggressive forms [5].Despite the fact that early diagnosis of symptomatic cancers is a worldwide priority [6], the literature on time intervals in chronic hematological malignancies is very scarce [7], and, the magnitude and the determining factors of the diagnostic interval (“diagnostic delay”) in PE-NHL are unknown. Considering this lack of studies, our objectives were to measure the diagnostic interval in PE-NHL of the head and neck and to analyze the clinical and pathological variables associated with this time interval

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