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Primary diffuse large B-cell lymphoma of the head and neck in a Brazilian single-center study
Paula Sabbo Bernardo1, Thaís Hancio1, Flavia da Cunha Vasconcelos1
1Laboratório de Hemato-Oncologia Celular e Molecular, Programa de Hemato-Oncologia Molecular, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil.
Insights
Head and neck diffuse large B-cell lymphoma (DLBCL) is common in middle-aged and elderly Brazilians. Treatment significantly improves overall survival, while advanced age, male gender, high LDH, and HIV positivity are linked to poorer outcomes.
Area of Science:
- Oncology
- Epidemiology
- Hematology
Background:
- Diffuse large B-cell lymphoma (DLBCL) accounts for a significant proportion of head and neck cancers.
- Understanding the epidemiological and survival characteristics of head and neck DLBCL is crucial for patient management.
Purpose of the Study:
- To characterize demographic parameters, anatomical sites, and survival rates of patients with head and neck DLBCL in a Brazilian cancer center.
- To identify factors associated with overall survival in this patient cohort.
Main Methods:
- Retrospective epidemiological study of 243 head and neck DLBCL patients.
- Data collected included demographics, tumor location, HIV status, lactate dehydrogenase (LDH) levels, and treatment modalities.
- Statistical analysis was performed to determine associations with overall survival.
Main Results:
- Waldeyer's ring was the most frequent primary tumor site.
- Age over 80, male gender, elevated LDH, and HIV positivity were associated with significantly shorter overall survival (OS).
- Treatment demonstrated a protective effect on OS, whereas combined chemotherapy and radiotherapy showed no additional benefit over isolated modalities.
Conclusions:
- Head and neck DLBCL predominantly affects middle-aged and elderly individuals, with a slight male predominance in the Brazilian population studied.
- A 3-year OS rate of nearly 60% was observed.
- Multivariate analysis identified treatment as the sole significant protective factor for OS.
Objectives:
Lymphomas represent around 10% of head and neck neoplasms, among which the diffuse large B-cell lymphoma (DLBCL) is the most common histologic subtype. In the present study, we characterized demographic parameters, anatomical sites, and survival rates of patients in a Brazilian cancer center.
Materials And Methods:
Single-center retrospective epidemiological study of 243 head and neck DLBCL patients. Demographic characteristics, tumor localization, HIV status, lactate dehydrogenase (LDH) activity, and treatment modality were obtained from electronic medical records.
Results:
The most common primary head and neck tumor location in patients with DLBCL was Waldeyer's ring. Interestingly, age above 80 years, male gender, high LDH levels, and HIV positivity were significantly associated with shorter overall survival (OS) rates and increased risk of death. We further demonstrated that treatment had a protective effect, improving OS, and reducing risk of death. Notably, we found no benefit of combination of chemotherapy and radiotherapy versus isolated treatment modalities.
Conclusion:
The study showed that primary head and neck DLBCL is more incident in middle age and elderly patients with a small male patients' majority in a Brazilian population. Moreover, we observed a 3-year OS rate of almost 60% and multivariate analysis showed that treatment was the only protective factor.
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