Time trends and survival of marginal zone lymphoma over 25 years in Girona, Spain (1994-2018).

OBJECTIVE: To analyze the incidence, incidence trends, and survival of marginal zone lymphomas (MZLs) in Girona and to describe these indicators based on the location in the case of extranodal MZLs. METHODS: Population-based study of MZL collected in the Girona Cancer Registry, 1994-2018. Sociodemographic data, tumor location, and stage were obtained from clinical records. Crude (CR) and age-adjusted (ASRE ) incidence rates expressed per 100,000 person-years (p-y) were calculated. Joinpoint regression models were used for the trend analysis according to the MZL group. Five-year observed and net survival were analyzed. RESULTS: A total of 472 MZLs were included, 44 (9.3%) were nodal, 288 (61.0%) extranodal, 122 (25.9%) splenic, and the rest (n = 18) MZL, NOS. The CR for the MZL was 2.89 × 100,000 p-y (95% CI: 2.63-3.15), the ASRE was 3.26 × 100,000 p-y (95% CI: 2.97-3.57), and the annual percentage change (APC) was 1.6 (95% CI: 0.5-2.7). The ASRE for nodal MZL was 0.30 × 100,000 p-y (95% CI: 0.22-0.41) and showed an APC of 2.9% (95% CI: -16.4-26.6). For extranodal MZL, the ASRE was 1.98 × 100,000 p-y (95% CI: 1.76-2.23) and the APC was -0.4 (95% CI: -2.0-1.2). The most frequent locations of this type of MZL were the gastric (35.4%), skin (13.2%), and respiratory system (11.8%). The ASRE of the splenic MZL was 0.85 (95% CI: 0.71-1.02) with an APC of 12.8 (95% CI: 2.5-24.0). The 5-year net survival of MZL was 82.1% (95% CI: 76.3-86.5). CONCLUSIONS: This study reveals differences in the incidence and trend of the incidence of MZL according to the subgroup, showing a significant increase in the overall MZL mainly due to splenic MZL type.

Conservative treatment in noninvasive breast cancer.

BACKGROUND: The elective treatment for noninvasive breast carcinoma has not yet been established. As a result of mammographic screening programs, the incidence of noninvasive tumors has increased and has lead to the same controversy already present had with invasive carcinomas: mastectomy or conserving therapy. METHODS: Since 1990, 101 patients with noninvasive breast cancer were treated with irradiation following breast-conserving surgery. All the patients had irradiation of the whole breast (mean dose, 47.6 +/- 1.2 Gy). The radiation dose boost to the tumor bed was delivered in 28.7% of the cases (mean dose, 21.03 +/- 3.06 Gy), and in 71.3%, the boost was not administered. RESULTS: With a median follow-up of 34 months, survival is 100%. The disease-free survival at 5 years by the Kaplan-Meier method is 93.6 +/- 8.65. CONCLUSIONS: The conserving treatment is a valid option for treatment of patients with ductal carcinoma in situ.