Diagnostic delay and outcome in immunocompetent patients with primary central nervous system lymphoma in Spain: a multicentric study
| العنوان: | Diagnostic delay and outcome in immunocompetent patients with primary central nervous system lymphoma in Spain: a multicentric study |
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| المؤلفون: | Ana Carolina Caballero, Jordi Bruna, N. Huertas, G García-Catalán, M. Solé-Rodríguez, M J Ibáñez-Juliá, P. Cacabelos, N Barbero-Bordallo, Ivan Dlouhy, Francesc Graus, Santiago Mercadal, A Muntañola, T Lado, M I Barceló, J M Sancho, Roser Velasco, L Gómez-Vicente, Noemi Vidal, Geltamo, J. Estela, R Caldú Agud, P. Martinez, E García Molina, Sabela Bobillo, I Camro, J. Gállego Pérez-Larraya, A Salar, M E Erro, María Concepción Ramírez Barón, Maite Encuentra, M Alañá |
| المساهمون: | Instituto de Salud Carlos III, European Commission |
| المصدر: | Journal of Neuro-Oncology r-IGTP. Repositorio Institucional de Producción Científica del Instituto de Investigación Germans Trias i Pujol instname JOURNAL OF NEURO-ONCOLOGY r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau Digital.CSIC. Repositorio Institucional del CSIC r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Male, Cancer Research, Multivariate analysis, Neurology, Delayed Diagnosis, medicine.medical_treatment, Central Nervous System Neoplasms, 0302 clinical medicine, Antineoplastic Combined Chemotherapy Protocols, Primary central nervous system lymphoma, Short survival, Outcome, Aged, 80 and over, medicine.diagnostic_test, Lymphoma, Non-Hodgkin, Cytarabine, Chemoradiotherapy, Middle Aged, Prognosis, Diagnostic delay, Survival Rate, Oncology, 030220 oncology & carcinogenesis, Steroids, Female, Immunocompetence, medicine.drug, Adult, medicine.medical_specialty, Prognostic factors, 03 medical and health sciences, Young Adult, Internal medicine, Biopsy, medicine, Humans, Aged, Retrospective Studies, Chemotherapy, Performance status, business.industry, medicine.disease, Carmustine, Methotrexate, Neurology (clinical), Cranial Irradiation, business, 030217 neurology & neurosurgery, Follow-Up Studies |
| الوصف: | GELTAMO and GENOSEN group. [Introduction] To assess the management of immunocompetent patients with primary central nervous system lymphomas (PCNSL) in Spain. [Methods] Retrospective analysis of 327 immunocompetent patients with histologically confirmed PCNSL diagnosed between 2005 and 2014 in 27 Spanish hospitals. [Results] 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 [Conclusions] Corticosteroids withdrawal before surgery does not decrease the risk of a negative biopsy but delays diagnosis. In this community-based study, only 73.4% of patients could receive HD-MTX-based chemotherapy and OS remains poor, particularly in elderly patients ≥ 70 years. This work was partially supported by Grant PI1501303 from ISCIII and Fondo Europeo de Desarrollo Regional (FEDER). |
| تدمد: | 1573-7373 0167-594X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::37f9fa0d22db62ba51a433796ab2ad4dTest https://pubmed.ncbi.nlm.nih.gov/32524392Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....37f9fa0d22db62ba51a433796ab2ad4d |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15737373 0167594X |
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