Primary Cutaneous Follicle Center Lymphoma: Demographic, Socioeconomic, and Clinical Prognostic Factors in a National Cohort.

Abstract

Primary cutaneous follicle center lymphoma (PCFCL) is a rare form of indolent B-cell lymphoma limited to the skin. This study aims to explore various factors affecting overall survival in patients with PCFCL using data from the National Cancer Database. Patients with PCFCL were identified in the National Cancer Database between 2004 and 2020 using the International Classification of Diseases for Oncology, Third Edition (ICD-O-3) histology code 9597. Time-to-event outcomes were analyzed with the Kaplan-Meier method, log-rank tests, and multivariable Cox hazard regression models to understand the association of demographic and prognostic factors on survival in patients with PCFCL. During the study interval, 1293 patients were identified with PCFCL, of which 64% were male, 50% were Stage I, and 84% had a Charlson-Deyo (CD) comorbidity score of 0. Key factors associated with worse overall survival included lower income ( P = 0.030), nonprivate insurance ( P < 0.001), and lower education levels ( P = 0.015). Additionally, female sex ( P = 0.014), older age ( P < 0.001), higher CD scores ( P < 0.001), stage II ( P = 0.013), stage III ( P = 0.003), and lack of primary radiation therapy ( P = 0.047) were associated with lower survival. Multivariate analysis confirmed that elevated comorbidity index [hazard ratio (HR) = 5.96, 95% confidence interval (CI): 2.82-12.59, P < 0.001], older age (HR = 1.57, 95% CI: 1.41-1.74, P < 0.001), and higher disease stage (Stage I vs II: HR = 2.15, 95% CI: 1.07-4.29, P = 0.031) were significantly associated with lower survival. In patients with PCFCL, female sex, older age, higher comorbidity index, higher disease stage, lower income, nonprivate insurance, and lower education levels were associated with lower overall survival.