Prognosis of Primary Thyroid Lymphoma: Demographic, Clinical, and Pathologic Predictors of Survival

The aim of this study is to assess associations between demographic, clinical and pathologic characteristics of patients with primary thyroid lymphoma (PTL) and survival, using both bivariate and multivariate analyses. We hypothesize that age, stage at diagnosis, and histology will be independent predictors of survival after diagnosis of PTL. Use of surgery to treat PTL will not improve survival. PTL patients were identified in the SEER database. Bivariate (χ2, Kaplan-Meier, and log rank) and multivariate (Cox proportional hazards) analyses were used to assess the associations between patient characteristics and survival. A total of 1,408 patients were identified. Overall, 98% had non-Hodgkin\u27s lymphoma; 68% had diffuse large B-cell, 10% follicular, 10% marginal zone, and 3% small lymphocytic. A total of 88% had stage I or II disease. Median survival was 9.3 years. On bivariate analysis, older age, single marital status, stage II-IV disease, histology (diffuse large B-cell, follicular, or other non-Hodgkin\u27s), earlier year of diagnosis, lack of prior malignancies, and no radiation or surgery predicted worse survival. Age ≥80 years, stage IV disease, no radiation or surgery, and large B-cell or follicular histology predicted worse prognosis in multivariate analysis. Based on the analysis, we conclude that older age, advanced stage, histologic subtype, and lack of radiation or surgical treatment are associated with worse survival. Thyroid resection offers benefit only for patients with stage I disease