title: Population-based prognostic factors for survival in patients with Burkitt lymphoma: an analysis from the Surveillance, Epidemiology, and End Results database.
abstract: BACKGROUND
  Burkitt lymphoma (BL) is an aggressive but potentially curable lymphoma, previously described in small, single-institution studies. This study evaluated prognostic factors for survival in adult patients with BL and a potential outcome improvement over the past decade in a population-based cohort.
  
  
  METHODS
  Adult patients with BL diagnosed between 1998 and 2009 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Prognostic factors were identified in a multivariate model for relative survival (RS), and trends in survival were evaluated using period analysis.
  
  
  RESULTS
  The study cohort included 2284 patients, with a median age of 49 years and male predominance (2.6:1). Gastrointestinal tract and the head and neck were the most common sites of extranodal disease. Older age, black race/ethnicity, and advanced stage were associated with a worse survival. In the period analysis, trends in improved survival between 1998 and 2009 were seen, except for patients older than 60 years and black patients, whose survival did not improve. A prognostic score divided patients into 4 groups: low-risk (5-year RS: 71%), low-intermediate (5-year RS: 55%), high-intermediate (5-year RS: 41%), and high-risk (5-year RS: 29%; P  < .001).
  
  
  CONCLUSIONS
  The outcome of patients younger than 60 years with BL improved over the past decade. Age, race, and stage have a prognostic role for survival. The proposed score can help inform prognosis in newly diagnosed patients and stratify participants in future trials.
authors.affiliation: Division of Hematology and Oncology, Alpert Medical School of Brown University, Rhode Island Hospital/The Miriam Hospital, Providence, Rhode Island.
authors.forename: Jorge J
authors.initials: JJ
authors.lastname: Castillo
authors.forename: Eric S
authors.initials: ES
authors.lastname: Winer
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Olszewski
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002051:Burkitt Lymphoma / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy; D015331:Cohort Studies; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012237:Rhode Island / Q000453:epidemiology; D018426:SEER Program; D015996:Survival Rate; D055815:Young Adult
keywords: Burkitt lymphoma; SEER; epidemiology; prognostic factors; race; rituximab