Risk Factors for Disease-Specific Mortality in Primary Central Nervous System Diffuse Large B-Cell Lymphoma Based on the SEER Database
XU Zhixiu
LI Zhuoran
LI Qing
MAO Xiaona
Abstract：Objective To analyze risk factors for disease-specific mortality in patients with primary central nervous system diffuse large B-cell lymphoma.Methods Patients diagnosed with primary central nervous system diffuse large B-cell lymphoma from 2000 to 2020 were selected from the Surveillance,Epidemiology,and End Results(SEER)database of the National Cancer Institute,which included data from 17 research centers.Fine-Gray test and multivariable competing risk models were applied to identify the independent risk factors for mortality in patients with primary central nervous system diffuse large B-cell lymphoma.Results A total of 3 550 patients were included in the study,among whom 35 patients died due to cerebrovascular diseases and 2 245 patients died due to tumor-related causes.Multivariable analysis showed that compared to patients aged 60 years,those aged 60-＜70 years and ≥ 70 years had significantly higher risks of cerebrovascular disease-related mortality(HR=3.511,95％CI:1.320-9.339,P=0.012;HR=4.212,95％CI:1.565-11.331,P=0.004)and tumor-specific mortality(HR=1.176,95％CI:1.052-1.314,P=0.004;HR=1.488,95％CI:1.339-1.652,P＜0.001).Multi-site involvement was associated with increased tumor-specific mortality compared to supratentorial involvement only(HR=1.184,95％CI:1.032-1.358,P=0.016).Partial or complete tumor resection reduced tumor-specific mortality risk compared to patients who did not undergo surgery(HR=0.755,95％CI:0.689-0.828,P＜0.001;HR=0.760,95％CI:0.645-0.896,P=0.001).Patients who received radiation therapy had a higher risk of death compared to those who did not receive radiation therapy(HR=1.106,95％CI:1.012-1.209,P=0.026),while chemotherapy had a lower risk of death compared to those who did not receive chemotherapy(HR=0.574,95％CI:0.521-0.632,P＜0.001).Conclusion Age ≥60 years is an independent risk factor for death due to cerebrovascular diseases and tumor-related causes.Multi-site involvement,receiving radiation therapy,not undergoing surgery,and not receiving chemotherapy are independent risk factors for tumor-related death.
Keywords：primary central nervous system lymphomadiffuse large B-cell lymphomadisease-specific mortalityrisk factor
Publication Date：2025-09-28
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：5( 3283-3287 )