Long term outcomes of 1263 patients with Mycosis fungoides and Sezary syndrome from 1982 to 2009
Clinical Cancer Research, 08/03/2012
Talpur R et al. – Improved outcome of MF/SS, reflected by overall survival and PFS for all stages, may result from earlier diagnosis, new therapies, and aggressive treatment of infections.Methods
- The prognostic variables effecting overall survival (OS) were examined in a unique prospective cohort of 1263 mycosis fungoides (MF) and Sézary Syndrome (SS) patients seen by one investigator at MD Anderson Cancer Center from 1982-2009.
- Kaplan and Meier estimates were used to determine median overall survival (OS), progression-free survival (PFS) and disease specific survival (DSS).
- Cox's proportional hazards regression model assessed prognostic factors.
- Mean age at diagnosis was 55.33 years. Early MF (Stage IA-IIA) represented 71.5% (903 of 1263) and advanced (Stage IIB-IVB), 28.5% (360 of 1263) patients.
- Progression to a higher stage occurred in 147 patients (11.6 %) of whom 112 (12%) were early and 35 (9.7%) advanced.
- Death from disease occurred in 102/1263 (8.1%) patients.
- Median OS was 24.44 years, PFS was 16 years, and median DSS was not reached.
- OS and PFS were significantly better for early stage patients with patches (T1a/T2a) than with patches/plaques (T1b/T2b).
- PFS analyzed in 1241 patients found only 337 (27.2%) had disease progression or had died from disease.
- Risk factors associated with progression or deaths were advanced age, plaque stage, LDH level, and tumor area.