Prognostic factors and nomogram for survival prediction in patients with primary pulmonary lymphoma: a SEER population-based study

Abstract

Primary pulmonary lymphomas (PPLs) are rare lymphoproliferative malignancies arising from the lungs. The prognostic factors and optimal management of PPL have not been clearly defined due to its rarity. This study sought to characterize the significant prognostic factors and develop a validated nomogram for individualized prediction of survival outcomes in patients with PPL. A total of 2325 patients diagnosed with PPL between 1983 and 2010 were identified using the Surveillance, Epidemiology, and End Results (SEER) database. Older age at diagnosis, males, Hispanic race, non-marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue histology, Ann Arbor stage IV were significantly associated with worse OS on multivariable analysis. All treatment modalities, including chemotherapy, surgery, and radiotherapy were independent predictors of survival on univariable analysis. The nomogram built demonstrated good discriminative ability and calibration, with the C-index of 0.690 and 0.730 in the training and validation cohorts, respectively.

Keywords:

• Primary pulmonary lymphoma
• survival
• prognosis
• nomogram

Acknowledgements

The authors appreciate the permission granted by SEER program for access to the database. We are grateful to Dr. Nguyen Lam Vuong from University of Medicine and Pharmacy at Ho Chi Minh City for his guidance on statistical analyses in this study.

Authors’ contributions

S.K.L. and G.M.T. designed the research under the supervision of N.T.H. S.K.L. and A.E. extracted the data. S.K.L. and A.H.Z. conducted all statistical analyses. S.K.L., M.D.N.T., and O.I. wrote the manuscript. All authors reviewed and approved the final version of manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine, Nagasaki University, Japan. The funding source has no role in study design; in data collection, analysis and interpretation; in the writing of the report; and in the decision to submit the manuscript for publication.