RARE-49. SEX-SPECIFIC SURVIVAL ANALYSIS IDENTIFIES DIFFERENTIAL CLUSTERS OF PROGNOSTIC RELEVANCE IN PATIENTS WITH PRIMARY CNS LYMPHOMA Article Swipe

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Thomas Roetzer , Karl‐Heinz Nenning , Julia Furtner , Lukas Seebrecht , Johanna Gesperger , Adelheid Wöehrer ·

YOU? · · 2019 · Open Access · · DOI: https://doi.org/10.1093/neuonc/noz175.1192

Sex-specific differences are increasingly recognized in various diseases but have not yet been investigated for patients with primary CNS lymphoma (PCNSL). We collected clinical information and MR-images from 130 patients with PCNSL (66 f/ 64 m). We segmented MR-images into contrast-enhanced tumor, necrosis and edema for volumetric analysis and additionally quantified anti-PCNSL immune response using anti-CD3 staining in 67 cases. Median overall survival was 10 months for females and 8 months for males (p=0.979). Sex-specific Cox-regression analyses implicated age, performance and immunodeficiency as significant prognostic markers in females, whereas only age remained as significant marker in males. We then performed cluster analyses for females (fC) and males (mC) with complete sets of clinical, imaging, and tissue phenotypes (n=55). In females, two main clusters emerged that were mainly driven by clinical performance with fC1 (n=14) featuring patients with better performance (most of whom received MTX) compared to fC2 (n=18; mOS 21 vs 3 months, p< 0.01). fC2 resolved into two subclusters with better outcome for fC2a based on larger enhancing tumor volume and high immune response (mOS 12 vs. 1 months, p< 0.01). In males, two major clusters emerged (16 vs 7 patients, mOS 5 vs 23 months, p=0.414).), which differed mainly according to treatment approach with higher prevalence of MTX-chemotherapy in mC1. Each cluster could be subdivided into 2 subclusters based on differences in clinical performance in mC1, or according to treatment strategy, i.e., combined chemo-radiotherapy vs radiotherapy-only or best supportive care (mOS 49 vs 2 months, p=0.12) in mC2. In summary, we find prognostically relevant sex-specific clusters in patients with PCNSL that implicate differential roles of tumor-related contrast enhancement and immune response in female versus treatment modality in male patients. Initial differences in cluster-defining factors need further validation in independent cohorts but might have implications for differential patient management.

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Medicine Internal medicine Proportional hazards model Immune system Lymphoma Oncology Primary central nervous system lymphoma Cluster (spacecraft) Subgroup analysis Immunology Confidence interval Computer science Programming language

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Type: article
Language: en
Landing Page: https://doi.org/10.1093/neuonc/noz175.1192
PDF: https://academic.oup.com/neuro-oncology/article-pdf/21/Supplement_6/vi232/30633605/noz175.1192.pdf
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DOI: https://doi.org/10.1093/neuonc/noz175.1192

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Title: RARE-49. SEX-SPECIFIC SURVIVAL ANALYSIS IDENTIFIES DIFFERENTIAL CLUSTERS OF PROGNOSTIC RELEVANCE IN PATIENTS WITH PRIMARY CNS LYMPHOMA

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Language: en

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Publication year: 2019

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Publication date: 2019-11-01

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Authors: Thomas Roetzer, Karl‐Heinz Nenning, Julia Furtner, Lukas Seebrecht, Johanna Gesperger, Adelheid Wöehrer

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Landing page: https://doi.org/10.1093/neuonc/noz175.1192

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Concepts: Medicine, Internal medicine, Proportional hazards model, Immune system, Lymphoma, Oncology, Primary central nervous system lymphoma, Cluster (spacecraft), Subgroup analysis, Immunology, Confidence interval, Computer science, Programming language

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abstract_inverted_index.we	253
abstract_inverted_index.(16	189
abstract_inverted_index.(66	33
abstract_inverted_index.130	29
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abstract_inverted_index.but	9, 293
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abstract_inverted_index.fC2	147, 156
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abstract_inverted_index.mOS	149, 193
abstract_inverted_index.not	11
abstract_inverted_index.two	121, 159, 185
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abstract_inverted_index.was	64
abstract_inverted_index.yet	12
abstract_inverted_index.(fC)	105
abstract_inverted_index.(mC)	108
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abstract_inverted_index.Each	213
abstract_inverted_index.MTX)	144
abstract_inverted_index.age,	79
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abstract_inverted_index.high	173
abstract_inverted_index.into	40, 158, 218
abstract_inverted_index.mC1,	228
abstract_inverted_index.mC1.	212
abstract_inverted_index.mC2.	250
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abstract_inverted_index.then	99
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abstract_inverted_index.whom	142
abstract_inverted_index.with	17, 31, 109, 132, 137, 161, 206, 261
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abstract_inverted_index.i.e.,	234
abstract_inverted_index.major	186
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abstract_inverted_index.(n=14)	134
abstract_inverted_index.(n=18;	148
abstract_inverted_index.0.01).	155, 182
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abstract_inverted_index.better	138, 162
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abstract_inverted_index.driven	128
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abstract_inverted_index.larger	168
abstract_inverted_index.mainly	127, 201
abstract_inverted_index.males,	184
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abstract_inverted_index.marker	95
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abstract_inverted_index.tumor,	42
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abstract_inverted_index.Initial	282
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abstract_inverted_index.females	68, 104
abstract_inverted_index.further	288
abstract_inverted_index.markers	86
abstract_inverted_index.months,	153, 180, 197, 247
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abstract_inverted_index.segmented	38
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abstract_inverted_index.anti-PCNSL	52
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abstract_inverted_index.independent	291
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abstract_inverted_index.p=0.414).),	198
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