Exploring the rarity: insights into primary diffuse large B-cell lymphoma of the prostate from a global retrospective analysis

Background

The purpose of this study is to comprehensively analyze cases of primary diffuse large B-cell lymphoma of the prostate (P-DLBCL-P) from a global perspective, aiming to understand the disease's characteristics, treatment responses, and outcomes. By doing so, we seek to establish a valuable reference for the clinical management of this rare malignancy.

Materials and methods

This study conducted a retrospective review of P-DLBCL-P cases reported worldwide, using various online databases, including PubMed, Scopus, and other English databases, as well as WanFang Data and China National Knowledge Infrastructure in Chinese, collecting clinical pathology information, treatment modalities, and prognosis of patients, and conducted survival analysis using the Kaplan-Meier method.

Results

A cohort comprising 68 patients was enrolled in this study. Lower urinary tract symptoms were prevalent in 90.63% of cases. Furthermore, 89.5% of patients exhibited prostate-specific antigen levels below the threshold of 4 ng/mL. Prostate biopsy was the most commonly used method, accounting for 52.38% of cases, followed by transurethral resection of the prostate at 33.33%. Approximately 33.90% of patients diagnosed with prostate lymphoma experienced stage IV disease, with the bladder or ureter being the organs most frequently involved (53.33%). Surgical procedures were associated with an elevated risk of uncontrollable hemorrhage. Notably, chemotherapy demonstrated a positive therapeutic response, resulting in a complete remission rate of 50.94% and a partial remission rate of 28.30%. A subsequent follow-up study revealed a 1-year survival rate of 73.08% and a 3-year survival rate of 65.38%.

Conclusions

The symptoms of P-DLBCL-P are often atypical, leading to many patients being diagnosed at a later stage of the disease. Through a global study of cases, we have confirmed the efficacy of the rituximab–cyclophosphamide–adriamycin–vincristine–prednisone regimen as the preferred treatment option. Surgical intervention is typically only used for diagnostic purposes or to relieve organ obstruction.