Primary Cutaneous Follicle Center Lymphoma: Demographic, Socioeconomic, and Clinical Prognostic Factors in a National Cohort.

Purpose: Primary cutaneous follicle center lymphoma (PCFCL) is a rare form of indolent B-cell lymphoma limited to the skin. This study aims to explore various factors affecting overall survival in patients with PCFCL using data from the National Cancer Database.

Methods: Patients with PCFCL were identified in the National Cancer Database between 2004 and 2020 using the International Classification of Diseases for Oncology, Third Edition (ICD-O-3) histology code 9597. Time-to-event outcomes were analyzed with the Kaplan-Meier method, log-rank tests, and multivariable Cox hazard regression models to understand the association of demographic and prognostic factors on survival in patients with PCFCL.

Results: During the study interval, 1293 patients were identified with PCFCL, of which 64% were male, 50% were Stage I, and 84% had a Charlson-Deyo (CD) comorbidity score of 0. Key factors associated with worse overall survival included lower income (P = 0.030), nonprivate insurance (P < 0.001), and lower education levels (P = 0.015). Additionally, female sex (P = 0.014), older age (P < 0.001), higher CD scores (P < 0.001), stage II (P = 0.013), stage III (P = 0.003), and lack of primary radiation therapy (P = 0.047) were associated with lower survival. Multivariate analysis confirmed that elevated comorbidity index [hazard ratio (HR) = 5.96, 95% confidence interval (CI): 2.82-12.59, P < 0.001], older age (HR = 1.57, 95% CI: 1.41-1.74, P < 0.001), and higher disease stage (Stage I vs II: HR = 2.15, 95% CI: 1.07-4.29, P = 0.031) were significantly associated with lower survival.

Conclusions: In patients with PCFCL, female sex, older age, higher comorbidity index, higher disease stage, lower income, nonprivate insurance, and lower education levels were associated with lower overall survival.