Risk Prediction for Early Mortality in Patients with Newly Diagnosed Primary CNS Lymphoma.

Abstract:

:Background: Overall survival of patients with primary CNS lymphoma (PCNSL) has improved since the introduction of immunochemotherapy. However, up to 10-15% of PCNSL patients still die shortly after diagnosis. In the present study, we aimed to investigate the risk factors of early mortality (death within 60 days after diagnosis) in patients with PCNSL. Methods: We included newly diagnosed PCNSL patients in a tertiary medical center in Taiwan between January 1, 2002 and May 31, 2018. Clinical risk factors were collected and compared between PCNSL patients who had and did not have early mortality. Results: A total of 133 consecutive patients with PCNSL were included in this study. Approximately 9.8% of the PCNSL patients had early mortality. In multivariate analysis, age ≥ 80 (adjusted hazard ratio [HR] 3.34, 95% confidence interval [CI] 1.01-11.04, p = 0.048) and involvement of the basal ganglia (adjusted HR 4.85, 95% CI 1.47-15.95, p = 0.009) were identified as independent risk factors of early mortality. Use of MTX-based chemotherapy served as an independent protective factor for early mortality (adjusted HR 0.19, 95% CI 0.05-0.67, p = 0.010). Infection and tumor-associated mass effect contributed most to early mortality. Conclusion: Early mortality is not uncommon in patients with PCNSL. Identification of patients with higher risk may help clinicians with initiating appropriate surveillance and management.

journal_name

J Cancer

journal_title

Journal of Cancer

authors

Lin CH,Yang CF,Yang HC,Fay LY,Yeh CM,Kuan AS,Wang HY,Gau JP,Hsiao LT,Chiou TJ,Chen PM,Liu YC,Ko PS,Liu JH,Liu CJ

doi

10.7150/jca.32467

subject

Has Abstract

pub_date

2019-07-05 00:00:00

pages

3958-3966

issue

17

issn

1837-9664

pii

jcav10p3958

journal_volume

10

pub_type

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