SPCR-11 DEMOGRAPHIC DISPARITIES AND PROGNOSTIC FACTORS IN PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA: A SEER DATABASE ANALYSIS

Abstract

Abstract Accounting for 3-4% of all central nervous system malignancies, primary CNS lymphoma (PCNSL) is a rare but aggressive form of extranodal non-Hodgkin lymphoma. Although recent studies have demonstrated an overall decline in the incidence, certain demographics are known to be more affected than others. We reviewed the queried Surveillance, Epidemiology, and End Results (SEER) database, 17 registries, Nov 2021 sub (2000-2019) for lymphoid neoplasm recode 2021 revision with primary site codes C69.1-69.4, C69.9-70.1, C70.9-72.5, C72.8-72.9. Patients of unknown race, ethnicity, and stage of the disease were excluded. We used Cox proportional hazard regression to assess the determinants of overall survival (OS) and cause-specific survival (CSS). Significance level was set to 0.05. Our search included 5910 patients. The mean age at diagnosis was 61.8 ± 15.8 years. Males accounted for 53.67% of the patients. Racial demographics showed a predominance of Whites (66.1%), followed by Hispanics (15.6%), Asian/pacific islanders (10.3%), Blacks (7.4%), and American Indians/Alaska Natives (0.45%). Most common histology was diffuse large B-cell lymphoma (67.74%). Most patients were diagnosed at stage I (76.5%), followed by stage IV (19.7%) of the disease. Older patients had worse OS (HR 1.03 [1.027;1.032]) and CSS (HR 1.021 [1.018;1.024]). Females had better OS 0.853 [0.803;0.9059]) and CSS (HR 0.8871 [0.8145;0.966]) compared to males. Indolent (follicular and marginal zone) lymphomas were associated with better OS (HR 0.3169 [0.2647-0.3759]) and CSS (HR 0.4265 [0.3494-0.5152]) compared to large B-cell lymphoma. Black patients had worse OS (1.608 [1.421-1.813]) and CSS (HR 1.385 [1.165-1.635]). While Hispanic ethnicity did not influence OS, it was associated with worse CSS (1.158 [1.025;1.304]). Stage at diagnosis did not have a statistically significant association with survival. These results suggest a need for additional research targeting high-risk demographics to develop tailored treatments, enhance care accessibility, and address possible inequities in the management of PCNSL.