Characterization and outcomes of local treatment for primary bladder lymphoma: A population-based cohort analysis

David P. Sellman, W. Greg Simpson, Zachary Klaassen, Rita P. Jen, John M. DiBianco, Lael Reinstatler, Qiang Li, Rabii Hussein Madi, Martha Kennedy Terris

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: Primary bladder lymphoma (PBL) is rare, representing 0.2% of extranodal lymphoma and less than 1% of all tumors originating in the bladder. Since the initial description of the disease, low-grade mucosa-associated lymphoid tissue (MALT) lymphoma has been reported as the most common subtype while high-grade disease was thought to represent only 20% of the reported cases. Materials and Methods: One hundred and ninety five patients with PBL from the Surveillance, Epidemiology, and End Results (SEER) registry from 1998-2010 were reviewed. Tumors were classified as high or low grade based on histologic subtype of lymphoma based on revised European-American Lymphoma classification system. Socio-demographic and clinical variables were reported, as well as survival outcome analyses using the Kaplan-Meier method and log-rank test. Cox proportional hazard analysis was used to generate hazard ratios for risk factors associated with mortality. Results: Eighty-three patients (42.6%) with low-grade and 112 patients (57.4%) with high-grade bladder lymphoma were studied. There were no differences between the low and high-grade groups for socio-demographic or clinical variables. Median overall survival or patients with low-grade disease was 38 months versus 15 months for patients with high-grade disease (p< 0.001). Analysis demonstrated worse survival outcomes for patients with high-grade disease compared to low-grade disease (p< 0.001). On multivariable analysis, increasing age and high-grade disease were associated with worse disease specific mortality (p< 0.001). Conclusion: Patient with high-grade primary bladder lymphoma had worse survival outcomes compared to those with low-grade disease. While transurethral resection provides tissue for diagnosis, immunotherapy/chemotherapy remains the mainstay of treatment for bladder lymphoma. Consolidation chemotherapy has been recommended in young patients not achieving complete remission with immunotherapy/chemotherapy.

Original languageEnglish (US)
Pages (from-to)249-253
Number of pages5
JournalUrology Annals
Volume10
Issue number3
DOIs
StatePublished - Jul 1 2018

Fingerprint

Lymphoma
Urinary Bladder
Cohort Studies
Population
Non-Hodgkin's Lymphoma
Immunotherapy
Survival
Consolidation Chemotherapy
Demography
Drug Therapy
Marginal Zone B-Cell Lymphoma
Mortality
Survival Analysis
Registries
Neoplasms
Epidemiology

Keywords

  • Bladder cancer
  • SEER
  • lymphoma
  • outcomes

ASJC Scopus subject areas

  • Urology

Cite this

Characterization and outcomes of local treatment for primary bladder lymphoma : A population-based cohort analysis. / Sellman, David P.; Simpson, W. Greg; Klaassen, Zachary; Jen, Rita P.; DiBianco, John M.; Reinstatler, Lael; Li, Qiang; Madi, Rabii Hussein; Terris, Martha Kennedy.

In: Urology Annals, Vol. 10, No. 3, 01.07.2018, p. 249-253.

Research output: Contribution to journalArticle

Sellman, David P. ; Simpson, W. Greg ; Klaassen, Zachary ; Jen, Rita P. ; DiBianco, John M. ; Reinstatler, Lael ; Li, Qiang ; Madi, Rabii Hussein ; Terris, Martha Kennedy. / Characterization and outcomes of local treatment for primary bladder lymphoma : A population-based cohort analysis. In: Urology Annals. 2018 ; Vol. 10, No. 3. pp. 249-253.
@article{04a53db04120452da085d0bde69cf81d,
title = "Characterization and outcomes of local treatment for primary bladder lymphoma: A population-based cohort analysis",
abstract = "Introduction: Primary bladder lymphoma (PBL) is rare, representing 0.2{\%} of extranodal lymphoma and less than 1{\%} of all tumors originating in the bladder. Since the initial description of the disease, low-grade mucosa-associated lymphoid tissue (MALT) lymphoma has been reported as the most common subtype while high-grade disease was thought to represent only 20{\%} of the reported cases. Materials and Methods: One hundred and ninety five patients with PBL from the Surveillance, Epidemiology, and End Results (SEER) registry from 1998-2010 were reviewed. Tumors were classified as high or low grade based on histologic subtype of lymphoma based on revised European-American Lymphoma classification system. Socio-demographic and clinical variables were reported, as well as survival outcome analyses using the Kaplan-Meier method and log-rank test. Cox proportional hazard analysis was used to generate hazard ratios for risk factors associated with mortality. Results: Eighty-three patients (42.6{\%}) with low-grade and 112 patients (57.4{\%}) with high-grade bladder lymphoma were studied. There were no differences between the low and high-grade groups for socio-demographic or clinical variables. Median overall survival or patients with low-grade disease was 38 months versus 15 months for patients with high-grade disease (p< 0.001). Analysis demonstrated worse survival outcomes for patients with high-grade disease compared to low-grade disease (p< 0.001). On multivariable analysis, increasing age and high-grade disease were associated with worse disease specific mortality (p< 0.001). Conclusion: Patient with high-grade primary bladder lymphoma had worse survival outcomes compared to those with low-grade disease. While transurethral resection provides tissue for diagnosis, immunotherapy/chemotherapy remains the mainstay of treatment for bladder lymphoma. Consolidation chemotherapy has been recommended in young patients not achieving complete remission with immunotherapy/chemotherapy.",
keywords = "Bladder cancer, SEER, lymphoma, outcomes",
author = "Sellman, {David P.} and Simpson, {W. Greg} and Zachary Klaassen and Jen, {Rita P.} and DiBianco, {John M.} and Lael Reinstatler and Qiang Li and Madi, {Rabii Hussein} and Terris, {Martha Kennedy}",
year = "2018",
month = "7",
day = "1",
doi = "10.4103/UA.UA_106_17",
language = "English (US)",
volume = "10",
pages = "249--253",
journal = "Urology Annals",
issn = "0974-7796",
publisher = "Medknow Publications and Media Pvt. Ltd",
number = "3",

}

TY - JOUR

T1 - Characterization and outcomes of local treatment for primary bladder lymphoma

T2 - A population-based cohort analysis

AU - Sellman, David P.

AU - Simpson, W. Greg

AU - Klaassen, Zachary

AU - Jen, Rita P.

AU - DiBianco, John M.

AU - Reinstatler, Lael

AU - Li, Qiang

AU - Madi, Rabii Hussein

AU - Terris, Martha Kennedy

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Introduction: Primary bladder lymphoma (PBL) is rare, representing 0.2% of extranodal lymphoma and less than 1% of all tumors originating in the bladder. Since the initial description of the disease, low-grade mucosa-associated lymphoid tissue (MALT) lymphoma has been reported as the most common subtype while high-grade disease was thought to represent only 20% of the reported cases. Materials and Methods: One hundred and ninety five patients with PBL from the Surveillance, Epidemiology, and End Results (SEER) registry from 1998-2010 were reviewed. Tumors were classified as high or low grade based on histologic subtype of lymphoma based on revised European-American Lymphoma classification system. Socio-demographic and clinical variables were reported, as well as survival outcome analyses using the Kaplan-Meier method and log-rank test. Cox proportional hazard analysis was used to generate hazard ratios for risk factors associated with mortality. Results: Eighty-three patients (42.6%) with low-grade and 112 patients (57.4%) with high-grade bladder lymphoma were studied. There were no differences between the low and high-grade groups for socio-demographic or clinical variables. Median overall survival or patients with low-grade disease was 38 months versus 15 months for patients with high-grade disease (p< 0.001). Analysis demonstrated worse survival outcomes for patients with high-grade disease compared to low-grade disease (p< 0.001). On multivariable analysis, increasing age and high-grade disease were associated with worse disease specific mortality (p< 0.001). Conclusion: Patient with high-grade primary bladder lymphoma had worse survival outcomes compared to those with low-grade disease. While transurethral resection provides tissue for diagnosis, immunotherapy/chemotherapy remains the mainstay of treatment for bladder lymphoma. Consolidation chemotherapy has been recommended in young patients not achieving complete remission with immunotherapy/chemotherapy.

AB - Introduction: Primary bladder lymphoma (PBL) is rare, representing 0.2% of extranodal lymphoma and less than 1% of all tumors originating in the bladder. Since the initial description of the disease, low-grade mucosa-associated lymphoid tissue (MALT) lymphoma has been reported as the most common subtype while high-grade disease was thought to represent only 20% of the reported cases. Materials and Methods: One hundred and ninety five patients with PBL from the Surveillance, Epidemiology, and End Results (SEER) registry from 1998-2010 were reviewed. Tumors were classified as high or low grade based on histologic subtype of lymphoma based on revised European-American Lymphoma classification system. Socio-demographic and clinical variables were reported, as well as survival outcome analyses using the Kaplan-Meier method and log-rank test. Cox proportional hazard analysis was used to generate hazard ratios for risk factors associated with mortality. Results: Eighty-three patients (42.6%) with low-grade and 112 patients (57.4%) with high-grade bladder lymphoma were studied. There were no differences between the low and high-grade groups for socio-demographic or clinical variables. Median overall survival or patients with low-grade disease was 38 months versus 15 months for patients with high-grade disease (p< 0.001). Analysis demonstrated worse survival outcomes for patients with high-grade disease compared to low-grade disease (p< 0.001). On multivariable analysis, increasing age and high-grade disease were associated with worse disease specific mortality (p< 0.001). Conclusion: Patient with high-grade primary bladder lymphoma had worse survival outcomes compared to those with low-grade disease. While transurethral resection provides tissue for diagnosis, immunotherapy/chemotherapy remains the mainstay of treatment for bladder lymphoma. Consolidation chemotherapy has been recommended in young patients not achieving complete remission with immunotherapy/chemotherapy.

KW - Bladder cancer

KW - SEER

KW - lymphoma

KW - outcomes

UR - http://www.scopus.com/inward/record.url?scp=85050313164&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85050313164&partnerID=8YFLogxK

U2 - 10.4103/UA.UA_106_17

DO - 10.4103/UA.UA_106_17

M3 - Article

AN - SCOPUS:85050313164

VL - 10

SP - 249

EP - 253

JO - Urology Annals

JF - Urology Annals

SN - 0974-7796

IS - 3

ER -