Changing Incidence and Survival of Primary Central Nervous System Lymphoma in Australia: A 33-Year National Population-Based Study
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Case Definitions
2.3. Statistical Analyses
2.4. Human Research Ethics
3. Results
3.1. Patient and Cancer Characteristics in The PCNSL Cohort
3.2. Incidence Rates and Trends for PCNSL, Non-CNS Lymphoma and Non-Hematological Primary CNS Cancers
3.3. Incidence Rates and Trends for CNS and Non-CNS DLBCL
3.4. Survival Outcomes for PCNSL, Non-CNS Lymphoma and Non-Hematological Primary CNS Cancers
3.5. Survival Outcomes for CNS and Non-CNS DLBCL
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | N (%) or Median (Range) |
---|---|
Median age at diagnosis (years) | 66 (20–100) |
Sex | ‒ |
Males | 734 (55.2) |
Females | 595 (44.8) |
Basis of diagnosis | ‒ |
Histopathology | 1189 (89.4) |
Cytology | 41 (3.1) |
Clinical diagnosis without tissue specimen | 86 (6.5) |
Other § | 13 (1.0) |
Prevalent types: ICD-O-3.1 Morphology Code | ‒ |
DLBCL | ‒ |
Strict definition: 9680, 9684 | 852 (64.1) |
Broad definition: 9590, 9591, 9675, 9680, 9684 | 1259 (94.7) |
T-cell, NK-cell lymphoma: 9702, 9714, 9719 | 24 (1.8) |
Other: 9590 | 239 (17.9) |
Distribution by initial site of CNS involvement | ‒ |
Brain | 1202 (90.4) |
Meninges | 23 (1.7) |
Spinal cord, cranial nerve, other | 104 (7.8) |
Cancer Subset | Age-Standardized § Incidence Per 100,000 Person-Years | |||||||
---|---|---|---|---|---|---|---|---|
Australian Standard Population | World Standard Population | |||||||
Observed Mean (95% CI) | AAPC (%) (95% CI) | Observed Mean (95% CI) | AAPC (%) (95% CI) | |||||
1982–2014 | 2000–2014 | 1982–2014 | 2000–2014 | 1982–2014 | 2000–2014 | 1982–2014 | 2000–2014 | |
PCNSL | 0.27 (0.21–0.33) | 0.43 (0.41–0.46) | 6.8 (1.7–12.2) * | 0.5 (−0.9–1.9) | 0.23 (0.18–0.28) | 0.36 (0.34–0.39) | 6.5 (3.0–10.1) * | −0.1 (−1.7–1.5) |
Non-CNS lymphoma | 20.58 (19.87–21.30) | 21.89 (21.41–22.38) | 1.1 (0.7–1.5) * | 0.7 (0.4–1) * | 16.91 (16.36–17.46) | 17.88 (17.48–18.27) | 1.0 (0.6–1.4) * | 0.7 (0.4–1) * |
CNS DLBCL | 0.16 (0.11–0.22) | 0.31 (0.2–0.33) | 11.3 (5.7–17.2) *,‡ | 2.1 (0.4–3.8) * | 0.14 (0.09–0.18) | 0.26 (0.24–0.28) | 10.1 (4.6–15.9) *,‡ | 2.1 (0.4–3.9) * |
Non-CNS DLBCL | 7.39 (6.80–7.98) | 8.60 (8.4–8.80) | 2.7 (2.2–3.1) * | 0.6 (0.3–0.9) * | 6.03 (5.56–6.49) | 6.94 (6.81–7.08) | 2.7 (2.2–3.1) * | 0.5 (0.2–0.8) * |
CNS non-DLBCL | 0.10 (0.09–0.12) | 0.12 (0.10–0.14) | 2.2 (−0.3–4.8) | −3.9 (−7–−0.7) * | 0.09 (0.08–0.10) | 0.10 (0.08–0.12) | 1.5 (−0.9–3.9) | −4.8 (−8.2–−1.3) * |
Non-CNS non-DLBCL | 13.19 (12.97–13.42) | 13.29 (12.91–13.66) | 0.5 (0.1–0.9) * | 0.6 (0–1.3) * | 10.88 (10.70–11.06) | 10.93 (10.61–11.25) | 0.4 (0–0.8) * | 0.7 (0.1–1.4) * |
Non-hematological CNS cancers | 9.03 (8.88–9.17) | 9.26 (9.07–9.45) | 0.0 (−0.3–0.3) | −0.5 (−1.2–0.3) | 7.96 (7.86–8.06) | 8.09 (7.93–8.25) | −0.1 (−0.4–0.3) | −0.5 (−1.2–0.2) |
Age (Years) | Age-Standardized § Incidence Per 100,000 Person-Years | |
---|---|---|
Observed Mean (95% CI) | AAPC (%) (95% CI) | |
20–29 | 0.03 (0.01–0.05) | –0.1 (-5.3–5.5) |
30–39 | 0.06 (0.04–0.08) | 2.1 (−1.9–6.4) |
40–49 | 0.14 (0.10–0.18) | 4.4 (1.0–7.8) * |
50–59 | 0.34 (0.29–0.37) | 3.0 (1.0–5.1) * |
60–69 | 0.77 (0.63–0.92) | 7.5 (4.8–10.2) * |
70–79 | 1.14 (1.00–1.28) | 2.6 (−1.1–6.4) |
≥80 | 0.76 (0.62–0.89) | 5.1 (1.8–8.6) * |
Cancer Subset | Time Interval | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
1982–2014 | 1982–1999 | 2000–2014 | p-Value * | |||||||
N | Median Survival (Days) (95% CI) | 5-Year Survival (Probability) (95% CI) | N | Median Survival (Days) (95% CI) | 5-Year Survival (Probability) (95% CI) | N | Median Survival (Days) (95% CI) | 5-Year Survival (Probability) (95% CI) | Overall Survival | |
PCNSL | 1329 | 522 (424–620) | 0.30 (0.27–0.33) | 283 | 318 (200–436) | 0.21 (0.16–0.26) | 1046 | 600 (465–734) | 0.33 (0.30–0.36) | <0.001 |
Non-CNS lymphoma | 92,464 | 2263 (2185–2267) | 0.54 (0.53–0.54) | 39,193 | 1318 (1278–1358) | 0.45 (0.44–0.45) | 53,271 | 3388 (3310–3466) | 0.62 (0.62–0.62) | <0.001 |
p-value § | <0.0001 | NA | NA | <0.0001 | NA | NA | <0.0001 | NA | NA | NA |
CNS DLBCL | 852 | 639 (482–796) | 0.33 (0.30–0.37) | 93 | 461 (297–625) | 0.24 (0.15–0.32) | 759 | 690 (500–880) | 0.34 (0.31–0.38) | 0.043 |
Non-CNS DLBCL | 33,997 | 1643 (1533–1667) | 0.49 (0.48–0.49) | 13,063 | 674 (632–716) | 0.38 (0.37–0.38) | 20,934 | 2679 (2565–2792) | 0.56 (0.56–0.57) | <0.001 |
p-value § | <0.0001 | NA | NA | <0.0001 | NA | NA | <0.0001 | NA | NA | NA |
CNS non-DLBCL | 477 | 337 (227–447) | 0.25 (0.21–0.29) | 190 | 244 (85–403) | 0.20 (0.14–0.25) | 287 | 425 (271–579) | 0.30 (0.24–0.35) | 0.01 |
Non-CNS non-DLBCL | 58,467 | 2553 (2500–2606) | 0.57 (0.57–0.57) | 26,130 | 1640 (1588–1692) | 0.48 (0.47–0.48) | 32,337 | 3773 (3666–3880) | 0.66 (0.65–0.66) | <0.001 |
p-value § | <0.0001 | NA | NA | <0.0001 | NA | NA | <0.0001 | NA | NA | NA |
Non-hematological CNS cancers | 40,326 | 277 (272–282) | 0.19 (0.19–0.20) | 18,151 | 222 (215–229) | 0.18 (0.17–0.18) | 22,175 | 329 (321–336) | 0.20 (0.20–0.21) | <0.0001 |
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Farrall, A.L.; Smith, J.R. Changing Incidence and Survival of Primary Central Nervous System Lymphoma in Australia: A 33-Year National Population-Based Study. Cancers 2021, 13, 403. https://doi.org/10.3390/cancers13030403
Farrall AL, Smith JR. Changing Incidence and Survival of Primary Central Nervous System Lymphoma in Australia: A 33-Year National Population-Based Study. Cancers. 2021; 13(3):403. https://doi.org/10.3390/cancers13030403
Chicago/Turabian StyleFarrall, Alexandra L., and Justine R. Smith. 2021. "Changing Incidence and Survival of Primary Central Nervous System Lymphoma in Australia: A 33-Year National Population-Based Study" Cancers 13, no. 3: 403. https://doi.org/10.3390/cancers13030403
APA StyleFarrall, A. L., & Smith, J. R. (2021). Changing Incidence and Survival of Primary Central Nervous System Lymphoma in Australia: A 33-Year National Population-Based Study. Cancers, 13(3), 403. https://doi.org/10.3390/cancers13030403