Survival and Recurrence in Vitreoretinal Lymphoma Simulating Uveitis at Presentation: The Possible Role of Combined Chemotherapy
Fabrizio Gozzi, Raffaella Aldigeri, Valentina Mastrofilippo, Luca De Simone, Elena Bolletta, Jacopo Marzano, Danilo Iannetta, Marco Coassin, Fiorella Ilariucci, Angela Ferrari, Stefano Luminari, Francesco Merli, Stefania Croci, Alessandro Zerbini, Enrico Farnetti, Davide Nicoli, Riccardo Valli, Ione Tamagnini, Alberto Cavazza, Carlo Salvarani, Luigi Fontana, Luca Cimino
Abstract
PURPOSE: To investigate the role of combined systemic and local chemotherapy in improving the survival of patients with vitreoretinal lymphoma (VRL). METHODS: Patients with VRL consecutively seen from 2006 to 2020 were retrospectively reviewed; data on the presence and time of central nervous system (CNS) involvement and treatment regimen (systemic, local or combined chemotherapy) were collected. Overall survival (OS) and progression-free survival (PFS) were calculated for each group. RESULTS: Forty-three eyes of 22 subjects with histology-proven VRL were included. Mean time of survival was 64.8 months (SE±10.8). Twelve patients (57%) presented CNS involvement, which was significantly associated with progression (r = 0.48, P = .03) and death (r = 0.56, P = .009). The isolated primary VRL group had a 5-year OS of 80%. Combined systemic and local chemotherapy reduced the risk of death by 82% (hazard ratio 0.18[0.04- 0.85]) in the entire cohort. CONCLUSION: Combined systemic and local chemotherapy significantly improved OS but not PFS of patients affected by VRL.