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Conventional Treatments Cannot Improve Outcomes of Early-Stage Primary Breast Marginal Zone Lymphoma

INTRODUCTION: Primary breast marginal zone lymphoma (PBMZL) is a rare occurrence and less is known about its characteristics, treatments, and outcomes. METHODS: We retrospectively reviewed 370 cases of early-stage PBMZL from the Surveillance, Epidemiology, and End Results database. Statistical analy...

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Autores principales: Liu, Hailing, Zhang, Jing, Quan, Lin, Cao, Lei, Miao, Yi, Zhao, Xiaoli, Shen, Haorui, Wang, Li, Xu, Wei, Li, Jianyong, Fan, Lei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8076799/
https://www.ncbi.nlm.nih.gov/pubmed/33928019
http://dx.doi.org/10.3389/fonc.2020.609512
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author Liu, Hailing
Zhang, Jing
Quan, Lin
Cao, Lei
Miao, Yi
Zhao, Xiaoli
Shen, Haorui
Wang, Li
Xu, Wei
Li, Jianyong
Fan, Lei
author_facet Liu, Hailing
Zhang, Jing
Quan, Lin
Cao, Lei
Miao, Yi
Zhao, Xiaoli
Shen, Haorui
Wang, Li
Xu, Wei
Li, Jianyong
Fan, Lei
author_sort Liu, Hailing
collection PubMed
description INTRODUCTION: Primary breast marginal zone lymphoma (PBMZL) is a rare occurrence and less is known about its characteristics, treatments, and outcomes. METHODS: We retrospectively reviewed 370 cases of early-stage PBMZL from the Surveillance, Epidemiology, and End Results database. Statistical analyses were performed to describe clinical features, determine prognostic factors, and compare different therapeutic strategies. RESULTS: At a median follow-up of 68.5 months, the 5-year overall survival (OS) and disease-specific survival (DSS) rate were 81.2 and 95.4%, respectively. We divided the cohort into four treatment groups and compared their characteristics and survival: radiotherapy (RT) ± surgery (Sx) (n = 142, 38.4%), Sx alone (n = 71, 19.2%), any chemotherapy (CT) (n = 63, 17.0%), and none of the above (n = 94, 25.4%). Age of onset and laterality of lesions tended to relate to the choice of different treatments. Multivariate Cox analysis showed that advanced age (>60 years), concomitant tumor, and any CT (vs RT ± Sx) predicted poorer OS, while for DSS, there was no meaningful indicator (P > 0.05). Patients aged >60 years or treated with any CT seemed to have shorter DSS, but the difference only approached statistical significance. Then we applied a propensity score-matched analysis to demonstrate that neither RT- nor Sx-containing therapy could bring a better OS or DSS. The competing risk model suggested that CT was the only contributor to higher PBMZL-specific mortality. CONCLUSION: Our results show an indolent behavior of early-stage PBMZL with long-term survival. Conventional oncological treatments fail to bring survival benefits; especially CT is detrimental to survival, suggesting that observation may be advisable in the management of early-stage PBMZL, and further research on novel targeted agents is warranted for patients in need.
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spelling pubmed-80767992021-04-28 Conventional Treatments Cannot Improve Outcomes of Early-Stage Primary Breast Marginal Zone Lymphoma Liu, Hailing Zhang, Jing Quan, Lin Cao, Lei Miao, Yi Zhao, Xiaoli Shen, Haorui Wang, Li Xu, Wei Li, Jianyong Fan, Lei Front Oncol Oncology INTRODUCTION: Primary breast marginal zone lymphoma (PBMZL) is a rare occurrence and less is known about its characteristics, treatments, and outcomes. METHODS: We retrospectively reviewed 370 cases of early-stage PBMZL from the Surveillance, Epidemiology, and End Results database. Statistical analyses were performed to describe clinical features, determine prognostic factors, and compare different therapeutic strategies. RESULTS: At a median follow-up of 68.5 months, the 5-year overall survival (OS) and disease-specific survival (DSS) rate were 81.2 and 95.4%, respectively. We divided the cohort into four treatment groups and compared their characteristics and survival: radiotherapy (RT) ± surgery (Sx) (n = 142, 38.4%), Sx alone (n = 71, 19.2%), any chemotherapy (CT) (n = 63, 17.0%), and none of the above (n = 94, 25.4%). Age of onset and laterality of lesions tended to relate to the choice of different treatments. Multivariate Cox analysis showed that advanced age (>60 years), concomitant tumor, and any CT (vs RT ± Sx) predicted poorer OS, while for DSS, there was no meaningful indicator (P > 0.05). Patients aged >60 years or treated with any CT seemed to have shorter DSS, but the difference only approached statistical significance. Then we applied a propensity score-matched analysis to demonstrate that neither RT- nor Sx-containing therapy could bring a better OS or DSS. The competing risk model suggested that CT was the only contributor to higher PBMZL-specific mortality. CONCLUSION: Our results show an indolent behavior of early-stage PBMZL with long-term survival. Conventional oncological treatments fail to bring survival benefits; especially CT is detrimental to survival, suggesting that observation may be advisable in the management of early-stage PBMZL, and further research on novel targeted agents is warranted for patients in need. Frontiers Media S.A. 2021-04-13 /pmc/articles/PMC8076799/ /pubmed/33928019 http://dx.doi.org/10.3389/fonc.2020.609512 Text en Copyright © 2021 Liu, Zhang, Quan, Cao, Miao, Zhao, Shen, Wang, Xu, Li and Fan https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Liu, Hailing
Zhang, Jing
Quan, Lin
Cao, Lei
Miao, Yi
Zhao, Xiaoli
Shen, Haorui
Wang, Li
Xu, Wei
Li, Jianyong
Fan, Lei
Conventional Treatments Cannot Improve Outcomes of Early-Stage Primary Breast Marginal Zone Lymphoma
title Conventional Treatments Cannot Improve Outcomes of Early-Stage Primary Breast Marginal Zone Lymphoma
title_full Conventional Treatments Cannot Improve Outcomes of Early-Stage Primary Breast Marginal Zone Lymphoma
title_fullStr Conventional Treatments Cannot Improve Outcomes of Early-Stage Primary Breast Marginal Zone Lymphoma
title_full_unstemmed Conventional Treatments Cannot Improve Outcomes of Early-Stage Primary Breast Marginal Zone Lymphoma
title_short Conventional Treatments Cannot Improve Outcomes of Early-Stage Primary Breast Marginal Zone Lymphoma
title_sort conventional treatments cannot improve outcomes of early-stage primary breast marginal zone lymphoma
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8076799/
https://www.ncbi.nlm.nih.gov/pubmed/33928019
http://dx.doi.org/10.3389/fonc.2020.609512
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