Primary thyroid lymphoma-clinical and prognosis factors analysis of 43 cases

Objective To discuss the clinical characters, diagnostic measures, the optimal management and to analyze local control and prognosis factors of primary thyroid lymphoma (PTL).Methods From 1972.1 to 2002.12, there were 43 cases with PTL treated in our hospital, of them, clinical characters and treatment results were analyzed. Statistics of Life table, COX regression and kaplane meier, log rank test were applied with SPPS10 software. Results When PTL had been growing, neck local lymphoid nodes were invaded first, The lowgrade of MZL?FL had good prognosis and less developing high grade lymphoma. The total 5, 10 year survival rates were 78% and 71% respectinely. The 5, 10 year free tumor survival rates were 78% and 78% respectively. Seven pts. with over stage Ⅱ, B symptom (2/3) and DLBCL (4/5) died of PTL. The results of COX regression show that the types of pathology, neck and system metastases, stage, B symptom markedly influenced the survival (P 0.001). The course of diseases also influenced the prognosis (P= 0.049). Nine pts. received thyroid operation had recurrences (9/11). The approaches of treatment influenced local control (P= 0.002)? Conclusion PTL had good prognosis. The pts with I EA low grade lymphoma may treated only with radiotherapy (RT) and Ⅱ EA with RT+chemotherapy (CT) after thyroid resection. But the pts with B symptom and/or high grade lymphoma should received CT which was stronger than CHOP. The local RT may given after the pts had complete release of diseases.