Diagnostic delay and outcome in immunocompetent patients with primary central nervous system lymphoma in Spain: a multicentric study.

Journal of Neuro-oncology
R VelascoGELTAMO and GENOSEN group

Abstract

To assess the management of immunocompetent patients with primary central nervous system lymphomas (PCNSL) in Spain. Retrospective analysis of 327 immunocompetent patients with histologically confirmed PCNSL diagnosed between 2005 and 2014 in 27 Spanish hospitals. Median age was 64 years (range: 19-84; 33% ≥ 70 years), 54% were men, and 59% had a performance status (PS) ≥ 2 at diagnosis. Median delay to diagnosis was 47 days (IQR 24-81). Diagnostic delay > 47 days was associated with PS ≥ 2 (OR 1.99; 95% CI 1.13-3.50; p = 0.016) and treatment with corticosteroids (OR 2.47; 95% CI 1.14-5.40; p = 0.023), and it did not improve over the years. Patients treated with corticosteroids (62%) had a higher risk of additional biopsies (11.7% vs 4.0%, p = 0.04) but corticosteroids withdrawal before surgery did not reduce this risk and increased the diagnostic delay (64 vs 40 days, p = 0.04). Median overall survival (OS) was 8.9 months [95% CI 5.9-11.7] for the whole series, including 52 (16%) patients that were not treated, and 14.1 months (95%CI 7.7-20.5) for the 240 (73.4%) patients that received high-dose methotrexate (HD-MTX)-based chemotherapy. Median OS was shorter in patients ≥ 70 years (4.1 vs. 13.4 months; p < 0.0001). Multivariat...Continue Reading

References

Mar 1, 1996·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·E M BessellS Villa
Mar 21, 1998·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·L E AbreyJ Yahalom
May 18, 1999·Journal of Neurology, Neurosurgery, and Psychiatry·L M DeAngelis
Nov 24, 1999·Journal of Neuro-oncology·M Weller
Jan 15, 2003·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Andrés J M FerreriFranco Cavalli
Feb 3, 2005·JAMA : the Journal of the American Medical Association·Susan M ChangUNKNOWN Glioma Outcomes Project Investigators
Jun 1, 2005·Journal of Neuro-oncology·Wilhelm KükerUlrich Herrlinger
Oct 18, 2005·Acta Oncologica·Ingfrid S HaldorsenOlav Mella
Jan 31, 2006·Neuro-oncology·Sara HoffmanBridget J McCarthy
Nov 23, 2006·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Lauren E AbreyLisa M DeAngelis
Jan 24, 2009·AJNR. American Journal of Neuroradiology·I S HaldorsenA Espeland
Mar 9, 2013·Der Pathologe·W BrückUNKNOWN Netzwerk Lymphome und Lymphomatoide Läsionen des Nervensystems
Apr 24, 2013·American Journal of Clinical Oncology·Hao XieDavid M Peereboom
Feb 24, 2015·Annals of Oncology : Official Journal of the European Society for Medical Oncology·B KasendaM Briel
Jul 8, 2015·The Lancet Oncology·Khê Hoang-XuanUNKNOWN European Association for Neuro-Oncology Task Force on Primary CNS Lymphoma
Aug 4, 2015·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·R CerquaL Provinciali
Jul 30, 2016·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Mashary BinnahilTejas Sankar
Jun 24, 2017·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Christian Grommes, Lisa M DeAngelis
Oct 7, 2017·European Journal of Haematology·Sandra ElorantaKarin Ekström-Smedby
Feb 21, 2019·Acta Haematologica·Tali Siegal, Osnat Bairey
Feb 21, 2019·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Caroline HouillierUNKNOWN Intergroupe GOELAMS–ANOCEF and the LOC Network for CNS Lymphoma

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