Incidence and survival trends in patients with primary tonsillar lymphoma: a large population-based study.

PURPOSE: This study aims to reveal changes in the incidence and prognosis of patients with tonsillar lymphoma on a population level. METHODS: The incidence, clinicopathological, and prognostic data of tonsillar lymphoma patients were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The Join-point software and R packages were utilized to analyze the annual percentage changes (APCs) and survival outcomes. RESULTS: The incidence of primary tonsillar lymphoma increased from 0.1204 per 100,000 person-years (95% CI, 0.0680-0.1962) in 1983 to 0.2158 (95% CI, 0.1675-0.2740) in 2015 with an APC of 1.20. When classified by decades, both cancer-specific survival (CSS) and overall survival (OS) improved with time. The 2006-2015 decade showed the highest rate of CSS and OS. Nevertheless, for disease-specific survival (DSS), the difference was not significant between 1996-2005 and 2006-2015 decades. The main cause of mortality among this cohort was heart diseases. Three nomograms were constructed to predict OS, CSS, and DSS for patients with primary tonsillar lymphoma, respectively. Histological subtype made the most contribution to poor prognosis in OS-predicting and CSS-predicting nomograms. While, for DSS, age at diagnosis made the most contribution to poor outcomes. CONCLUSIONS: The incidence of primary tonsillar lymphoma has increased in the past decades. The OS and CSS rates of tonsillar lymphoma improved continuously, while there was no significant improvement in DSS in the past decades. These changes indicated an improved management of tonsillar lymphoma with newer therapeutic agents and the need of multi-disciplinary treatments to offset the future burden of noncancer diseases.

[Extranodal lymphomas in adults in Szabolcs-Szatmár-Bereg county, Hungary. Analysis of 30 years' epidemiologic data]. / Extranodalis lymphomák Szabolcs-Szatmár-Bereg megye felnott lakossága körében. 30 év adatainak elemzése.

INTRODUCTION: In their previous work, the authors reported 27-year' findings on the epidemiology of extranodal lymphomas in Szabolcs-Szatmár-Bereg county, Hungary. There are no other studies on this topic available in Hungary. AIM: The aim of this study was to analyse in detail the epidemiologic data of patients with non-Hodgkin's lymphoma who were recorded in the leukaemia/lymphoma registry of Szabolcs-Szatmár-Bereg county during a 30-year period, to compare the main epidemiologic features of the extranodal and nodal forms, and compare the results with data reported in the international literature. METHOD: Between January 1, 1983 and December 31, 2012, 1123 adult patients with newly diagnosed non-Hodgkin's lymphoma were recorded in the leukaemia/lymphoma registry of Szabolcs-Szatmár-Bereg county. Of those, 347 patients suffered from extranodal, and 776 patients from nodal form of non-Hodgkin's lymphoma. The authors compared the incidence of the extranodal and nodal forms, the age and sex distribution of patients, the ratio of B- and T-cell, as well as the indolent and aggressive forms, the geographic distribution and the association with carcinomas. In addition, they studied the occurrence of familial appearance and the localisation of extranodal forms. RESULTS: The occurrence of non-Hodgkin's lymphomas indicated an increasing tendency in their county. This tendency was true for both the extranodal and nodal forms, but it was more remarkable in the extranodal form of lymphomas. They found no substantial difference between the main epidemiologic features of the two forms. The gastrointestinal tract was the most frequent site of presentation for extranodal lymphomas. CONCLUSIONS: These observations are in line with data reported in the international literature. The data are essentially similar to those published in populations from Western European countries and the United States.

A Survival Analysis of Pediatric Tonsillar Malignancies and Review of a Rare Case.

OBJECTIVE: To examine the survival of pediatric tonsillar cancer patients and review a rare case of pediatric tonsillar cancer. METHODS: Pediatric patients in the Surveillance, Epidemiology, and End Results (SEER) database were included from 1973 to 2014 based on a diagnosis of tonsillar malignancy using the ICD O-3 tonsil primary site codes of: C09.0, C09.1, C09.8, and C09.9. Patients were included from birth-18 years. Survival analysis was performed using Kaplan-Meier analysis. Additionally, a case of pediatric natural killer (NK) cell tonsillar lymphoma diagnosed and treated at the Nemours Children's hospital in Orlando, Florida is presented. RESULTS: One hundred forty-one cases of tonsil cancer were identified. The mean age at diagnosis was 9.9 years (SD: 5.1, range: 0.0 (months)-18.0). Ninety five (67.4%) patients were male and 116 (82.3%) had unilateral malignancies. Burkitt lymphoma (32.6%) followed by diffuse large B-cell lymphoma (DLBCL) (27.0%) were the two most common histological types of tonsillar cancers. 79.4% of patients received chemotherapy and 81.6% received surgery as a part of their care. The 5-year disease-specific survival rate was >90% for patient cohorts diagnosed from 1984 to 1993, 1994-2003, and 2004-2014 as compared to 64% for patients diagnosed from 1973 to 1983 (p = 0.01). CONCLUSIONS: Survival rates for pediatric patients with tonsillar cancer are excellent. Pediatric primary tonsil cancer occurred most commonly in adolescent males and usually presents as a unilateral mass. Lymphoma remains the predominant histological type of cancer. Most patients are likely to receive surgery and chemotherapy.