Age-related differences in primary central nervous system lymphomas based on the SEER database

Area of Science:

• Neuro-oncology
• Hematology
• Epidemiology

Background:

• Primary central nervous system lymphoma (PCNSL) is a rare and aggressive non-Hodgkin lymphoma.
• Understanding prognostic factors and survival outcomes is crucial for optimizing patient care.

Purpose of the Study:

• To compare prognostic factors and survival outcomes in patients with primary central nervous system lymphoma (PCNSL).
• To evaluate the impact of age, treatment modalities, and demographic factors on PCNSL patient survival.

Main Methods:

• Utilized the Surveillance, Epidemiology, and End Results (SEER) database for PCNSL patients diagnosed between 2000 and 2019.
• Analyzed a cohort of 5,812 PCNSL patients, stratifying them into younger (≤60 years) and older (>60 years) groups.
• Developed a nomogram to predict overall survival (OS) for diffuse large B-cell lymphoma (PCNS-DLBCL) subtypes.

Main Results:

• Younger PCNSL patients (≤60) had better survival outcomes, higher rates of early-stage diagnosis, and received more chemotherapy and radiotherapy.
• Diffuse large B-cell lymphoma (PCNS-DLBCL) was the most common subtype.
• Combined therapy of surgery and chemotherapy significantly improved OS and reduced disease-specific mortality (DSM) in all age groups.
• Older patients receiving surgery, chemotherapy, and radiotherapy showed improved OS and DSM.
• African American patients and higher Ann Arbor stage were associated with poorer OS and DSM.

Conclusions:

• Age is a significant factor influencing OS and DSM in PCNSL patients, with distinct independent factors affecting outcomes in different age cohorts.
• The developed nomogram demonstrated high accuracy in predicting OS for PCNS-DLBCL patients.
• Multimodal treatment, particularly the combination of chemotherapy and surgical resection, offers improved survival benefits for PCNSL patients.