Sites of extranodal involvement are prognostic in patients with stage 1 follicular lymphoma

Aditi Shastri, Murali Janakiram, Ioannis Mantzaris, Yiting Yu, Jaime S. Londono, Amit K. Verma, Stefan K. Barta

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objectives: Follicular lymphoma (FL) is the most common indolent B cell lymphoma in the United States and a quarter of patients present with stage I disease. The objective of this study was to examine if primary site of disease influences survival in early stage lymphoma. Results: The most common extranodal primary sites were the integumentary system (8%), followed by the GI tract (6.4%) and head & neck (5.6%). We stratified patients into a pre-rituximab era (1983-1998) and the rituximab era (1999-2011). In multivariable analysis, integumentary disease was associated with better overall survival (Hazard Ratio [HR], 0.77; Confidence Interval [CI], 0.66-0.9) while primary site FL of the nervous system (HR, 2.40; CI, 1.72-3.38) and the musculoskeletal system (HR, 2.14; CI, 1.44-3.18) were associated with worse overall survival when compared to primary nodal FL. Treatment in the pre-rituximab era, male gender and older age at diagnosis were associated with worse survival. Methods: We queried the SEER database from 1983 to 2011. We included all adult patients (> 18 years) with histologically confirmed stage I FL, active follow-up, and a single primary tumor. A total of 9,865 patients met eligibility criteria, with 2520 (25%) having an extranodal primary site. We classified the primary sites by organ or anatomic location into 11 sites. Conclusion: Primary site of disease is a prognostic factor for patients with early stage FL and may help identify subsets of patients that could benefit from early, aggressive treatment.

Original languageEnglish (US)
Pages (from-to)78410-78418
Number of pages9
JournalOncotarget
Volume8
Issue number45
DOIs
StatePublished - 2017

Fingerprint

Follicular Lymphoma
Survival
Confidence Intervals
Integumentary System
Musculoskeletal System
B-Cell Lymphoma
Nervous System
Gastrointestinal Tract
Lymphoma
Neck
Head
Databases
Therapeutics
Rituximab
Neoplasms

Keywords

  • Epidemiology and End Results database
  • Extranodal disease
  • Follicular lymphoma
  • Prognosis
  • Surveillance

ASJC Scopus subject areas

  • Oncology

Cite this

Sites of extranodal involvement are prognostic in patients with stage 1 follicular lymphoma. / Shastri, Aditi; Janakiram, Murali; Mantzaris, Ioannis; Yu, Yiting; Londono, Jaime S.; Verma, Amit K.; Barta, Stefan K.

In: Oncotarget, Vol. 8, No. 45, 2017, p. 78410-78418.

Research output: Contribution to journalArticle

Shastri, Aditi ; Janakiram, Murali ; Mantzaris, Ioannis ; Yu, Yiting ; Londono, Jaime S. ; Verma, Amit K. ; Barta, Stefan K. / Sites of extranodal involvement are prognostic in patients with stage 1 follicular lymphoma. In: Oncotarget. 2017 ; Vol. 8, No. 45. pp. 78410-78418.
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abstract = "Objectives: Follicular lymphoma (FL) is the most common indolent B cell lymphoma in the United States and a quarter of patients present with stage I disease. The objective of this study was to examine if primary site of disease influences survival in early stage lymphoma. Results: The most common extranodal primary sites were the integumentary system (8{\%}), followed by the GI tract (6.4{\%}) and head & neck (5.6{\%}). We stratified patients into a pre-rituximab era (1983-1998) and the rituximab era (1999-2011). In multivariable analysis, integumentary disease was associated with better overall survival (Hazard Ratio [HR], 0.77; Confidence Interval [CI], 0.66-0.9) while primary site FL of the nervous system (HR, 2.40; CI, 1.72-3.38) and the musculoskeletal system (HR, 2.14; CI, 1.44-3.18) were associated with worse overall survival when compared to primary nodal FL. Treatment in the pre-rituximab era, male gender and older age at diagnosis were associated with worse survival. Methods: We queried the SEER database from 1983 to 2011. We included all adult patients (> 18 years) with histologically confirmed stage I FL, active follow-up, and a single primary tumor. A total of 9,865 patients met eligibility criteria, with 2520 (25{\%}) having an extranodal primary site. We classified the primary sites by organ or anatomic location into 11 sites. Conclusion: Primary site of disease is a prognostic factor for patients with early stage FL and may help identify subsets of patients that could benefit from early, aggressive treatment.",
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T1 - Sites of extranodal involvement are prognostic in patients with stage 1 follicular lymphoma

AU - Shastri, Aditi

AU - Janakiram, Murali

AU - Mantzaris, Ioannis

AU - Yu, Yiting

AU - Londono, Jaime S.

AU - Verma, Amit K.

AU - Barta, Stefan K.

PY - 2017

Y1 - 2017

N2 - Objectives: Follicular lymphoma (FL) is the most common indolent B cell lymphoma in the United States and a quarter of patients present with stage I disease. The objective of this study was to examine if primary site of disease influences survival in early stage lymphoma. Results: The most common extranodal primary sites were the integumentary system (8%), followed by the GI tract (6.4%) and head & neck (5.6%). We stratified patients into a pre-rituximab era (1983-1998) and the rituximab era (1999-2011). In multivariable analysis, integumentary disease was associated with better overall survival (Hazard Ratio [HR], 0.77; Confidence Interval [CI], 0.66-0.9) while primary site FL of the nervous system (HR, 2.40; CI, 1.72-3.38) and the musculoskeletal system (HR, 2.14; CI, 1.44-3.18) were associated with worse overall survival when compared to primary nodal FL. Treatment in the pre-rituximab era, male gender and older age at diagnosis were associated with worse survival. Methods: We queried the SEER database from 1983 to 2011. We included all adult patients (> 18 years) with histologically confirmed stage I FL, active follow-up, and a single primary tumor. A total of 9,865 patients met eligibility criteria, with 2520 (25%) having an extranodal primary site. We classified the primary sites by organ or anatomic location into 11 sites. Conclusion: Primary site of disease is a prognostic factor for patients with early stage FL and may help identify subsets of patients that could benefit from early, aggressive treatment.

AB - Objectives: Follicular lymphoma (FL) is the most common indolent B cell lymphoma in the United States and a quarter of patients present with stage I disease. The objective of this study was to examine if primary site of disease influences survival in early stage lymphoma. Results: The most common extranodal primary sites were the integumentary system (8%), followed by the GI tract (6.4%) and head & neck (5.6%). We stratified patients into a pre-rituximab era (1983-1998) and the rituximab era (1999-2011). In multivariable analysis, integumentary disease was associated with better overall survival (Hazard Ratio [HR], 0.77; Confidence Interval [CI], 0.66-0.9) while primary site FL of the nervous system (HR, 2.40; CI, 1.72-3.38) and the musculoskeletal system (HR, 2.14; CI, 1.44-3.18) were associated with worse overall survival when compared to primary nodal FL. Treatment in the pre-rituximab era, male gender and older age at diagnosis were associated with worse survival. Methods: We queried the SEER database from 1983 to 2011. We included all adult patients (> 18 years) with histologically confirmed stage I FL, active follow-up, and a single primary tumor. A total of 9,865 patients met eligibility criteria, with 2520 (25%) having an extranodal primary site. We classified the primary sites by organ or anatomic location into 11 sites. Conclusion: Primary site of disease is a prognostic factor for patients with early stage FL and may help identify subsets of patients that could benefit from early, aggressive treatment.

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