Diagnosis, treatment, and outcome of primary CNS lymphoma—a single-center experience

Joakim Wismann*, Rune Hørlykke Sommer-Sørensen, Mikkel Seremet Kofoed, Bo Halle, Christian Bonde Pedersen, Mette Katrine Schulz, Mads Hjortdal Grønhøj, Thomas Stauffer Larsen, Michael Boe Møller, Frantz Rom Poulsen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Background: Primary CNS lymphoma (PCNSL) is a highly aggressive non-Hodgkin lymphoma (NHL) that occurs in the CNS (e.g. brain, meninges, spinal cord, cerebrospinal fluid, or intraocular involvement) in the absence of systemic NHL. Tumor resection does not improve survival, and neurosurgical intervention is generally limited to stereotactic biopsy to provide a histopathological diagnosis. Objective: The objective of this single-center study was to evaluate the management and outcome of PCNSL patients diagnosed by biopsy, using overall survival and progression-free survival as endpoints. Methods: At our department of neurosurgery, 140 patients were diagnosed with PCNSL by biopsy between January 1, 2009, and December 31, 2018. Of these, 37 patients were included in the study and were divided into three groups according to their postoperative therapy. Results: Median OS was 35.7 months for the intensive treatment group, 29.5 months for the moderate treatment group, and 8.6 months for the palliative treatment group. The intensive and moderate treatment groups had similar progression-free survival, while the palliative treatment group had poor overall and progression-free survival. Six patients were long-term survivors (> 80 months). Age under 65 years was the main significant parameter affecting overall survival. Conclusion: In this cohort, patients with PCNSL had an overall fair prognosis if they (1) were under 65 years old, (2) had a performance score < 2 at the time of diagnosis, and (3) received either intensive or moderate chemotherapeutic treatment. Biopsy is still the primary diagnostic tool; other methods have been investigated but are not yet recommended.

Original languageEnglish
JournalActa Neurochirurgica
Volume164
Issue number5
Pages (from-to)1365-1373
ISSN0001-6268
DOIs
Publication statusPublished - May 2022

Keywords

  • Brain biopsy
  • Overall survival
  • PCNSL
  • Progression-free survival
  • Prognosis
  • Humans
  • Treatment Outcome
  • Brain/pathology
  • Progression-Free Survival
  • Aged
  • Retrospective Studies
  • Central Nervous System Neoplasms/diagnosis
  • Lymphoma, Non-Hodgkin/diagnosis
  • Neurosurgical Procedures/methods
  • Cohort Studies

Fingerprint

Dive into the research topics of 'Diagnosis, treatment, and outcome of primary CNS lymphoma—a single-center experience'. Together they form a unique fingerprint.

Cite this