Evidence map›Paper›PMID 32140975›Full record

ArticleJournal of neuro-oncology2020

Patterns of relapse after successful completion of initial therapy in primary central nervous system lymphoma: a case series.

Mallika P Patel, John P Kirkpatrick, Margaret O Johnson, Patrick Healy, James E Herndon, Eric S Lipp, Elizabeth S Miller, Annick Desjardins, Dina Randazzo, Henry S Friedman and 2 more

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Article in Journal of neuro-oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.4field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 2 institutions in 1 country.

Mallika P PatelDepartment of Pharmacy, Duke University Medical Center, Durham, NC, USA. mallika.patel@duke.edu.
John P KirkpatrickDepartment of Radiation Oncology, Duke University Medical Center, Durham, NC, USA.
Margaret O JohnsonDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Patrick HealyDuke Cancer Institute, Duke University Medical Center, Durham, NC, USA.
James E HerndonDepartment of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA.
Eric S LippDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Elizabeth S MillerDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Annick DesjardinsDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Dina RandazzoDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Henry S FriedmanDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
David M AshleyDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Katherine B PetersDepartment of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
Duke Medical Center · USDuke University Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePrimary central nervous system lymphoma (PCNSL) is a subtype of non-Hodgkin's lymphoma that involves the brain, spinal cord, or leptomeninges, without evidence of systemic disease. This rare disease accounts for ~ 3% of all primary central nervous system (CNS) tumors. Methotrexate-based regimens are the standard of care for this disease with overall survival rates ranging from 14 to 55 months. Relapse after apparent complete remission can occur. We sought to understand the outcomes of patients who relapsed.

methodsThis is an IRB-approved investigation of patients treated at our institution between 12/31/2004 and 10/12/2016. We retrospectively identified all cases of PCNSL as part of a database registry and evaluated these cases for demographic information, absence or presence of relapse, location of relapse, treatment regimens, and median relapse-free survival.

resultsThis analysis identified 44 patients with a pathologically confirmed diagnosis of PCNSL. Mean age at diagnosis was 63.1 years (range 20-86, SD = 13.2 years). Of the 44 patients, 28 patients successfully completed an initial treatment regimen without recurrence or toxicity that required a change in therapy. Relapse occurred in 11 patients with the location of relapse being in the CNS only (n = 5), vitreous fluid only (n = 1), outside CNS only (n = 3), or a combination of CNS and outside of the CNS (n = 2). Sites of relapse outside of the CNS included testes (n = 1), lung (n = 1), adrenal gland (n = 1), kidney/adrenal gland (n = 1), and retroperitoneum (n = 1). Median relapse-free survival after successful completion of therapy was 6.7 years (95% CI 1.1, 12.6).

conclusionAfter successful initial treatment, PCNSL has a propensity to relapse, and this relapse can occur both inside and outside of the CNS. Vigilant monitoring of off-treatment patients with a history of PCNSL is necessary to guide early diagnosis of relapse and to initiate aggressive treatment.

Indexed as

AdultAgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsCentral Nervous System NeoplasmsFemaleFollow-Up StudiesHumansInduction ChemotherapyLymphoma, Non-HodgkinMaleMiddle AgedNeoplasm Recurrence, LocalNorth CarolinaPrognosisRetrospective StudiesCentral nervous system lymphomaExtranodal sitesPCNSLRelapsed disease

Identifiers

PMID32140975
OpenAlexW3009934713

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.