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Predicting the risk of distant and local recurrence for patients with ocular adnexal extranodal marginal zone lymphoma: a matched case–control study
  1. Jiahao Shi1,2,
  2. Tianyu Zhu1,2,
  3. Min Zhou1,2,
  4. Xiaowen Zhou1,2,
  5. Xin Song1,2,
  6. Yefei Wang1,2,
  7. Renbing Jia1,2,
  8. Ziyao Yu1,2,
  9. Yixiong Zhou1,2,
  10. Xianqun Fan1,2
  1. 1Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
  2. 2Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
  1. Correspondence to Dr Yixiong Zhou, Department of Ophthalmology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; zhouyixiong21{at}gmail.com; Professor Xianqun Fan, Department of Ophthalmology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; fanxq{at}sjtu.edu.cn

Abstract

Background/aims Extranodal marginal zone lymphoma of ocular adnexa (OA-EMZL) is the most frequent type of ocular adnexal lymphomas, with a high rate of disease recurrence. Precise patient stratification based on disease recurrence is understudied. This study aims to identify risk factors of distant recurrence (DR) and local recurrence (LR) to construct a prognostic model optimising rapid decision of therapeutic strategies.

Methods A total of 104 patients diagnosed with OA-EMZL between January 2011 and February 2020 were enrolled. Propensity score matching was performed for DR and LR groups. A nomogram was generated using a multivariate Cox proportional hazards model.

Results After matching, different independent risk factors of DR and LR were identified. Monocyte percentage (p=0.015) and M category >0 (p=0.043) were significant independent risk factors of DR. Epiphora (p<0.001) was the significant independent risk factor of LR. Three factors (monocyte percentage, M category >0, age >60) were integrated into the nomogram to predict the risk of DR. It had a relatively better discriminative ability for distant recurrence-free survival (C-index: 3-year, 0.784; 6-year, 0.801) than IPI score (C-index: 3-year, 0.663; 6-year, 0.673) in the cohort of all patients.

Conclusion Our analyses suggested DR and LR as two distinct prognostic events, and additionally identified novel risk factors of them. The nomogram may serve as a practical tool for the prognostic estimation and rapid decision of therapeutic strategies for patients with OA-EMZL.

  • Orbit
  • Neoplasia

Data availability statement

Data are available upon reasonable request. Data are available upon reasonable request. The data used to support the findings of this study are available from the corresponding author upon request.

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Data availability statement

Data are available upon reasonable request. Data are available upon reasonable request. The data used to support the findings of this study are available from the corresponding author upon request.

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Footnotes

  • JS and TZ contributed equally.

  • Contributors JS and TZ conceived the study concept and design. JS, TZ, YW, XS and ZY recruited, screened the participants and collected information on related factors, including outdoor time and puberty stages. MZ, YZ and RJ conducted the optical examination. JS prepared the first draft of the manuscript. TZ, YZ, WZ and XF all provided edits and critiqued the manuscript for intellectual content. JS, TZ, YZ and XF had full access to the data, took responsibility for the overall content, and controlled the decision to publish.

  • Funding This work was supported by the Project of Biobank of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine (grant number YBKA201907) and National Natural Science Foundation of China (grant number 81802739). The funding organisation had no role in the design or conduct of this research.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.