Background/Objectives:The management of primary central nervous system lymphoma (PCNSL) has traditionally prioritized diagnostic biopsy, with surgical resection often considered secondary due to risks and potential bias in previous studies, which included patients with deep or multiple tumors. This study aims to evaluate the impact of surgical resection on survival in patients with solitary, resectable PCNSL.Methods:We conducted a retrospective analysis of PCNSL patients treated via brain biopsy or surgical resection at our institution between January 2010 and December 2022. Cases with deep-located tumors (corpus callosum, basal ganglia, thalamus, and brainstem) or multiple lesions were excluded. Survival and clinical outcomes were compared between the two groups.Results:A total of 79 patients (30 resection and 49 biopsy) were included. No significant differences were observed between groups regarding demographics, comorbidities, tumor characteristics, or International Extranodal Lymphoma Study Group scores. Preoperative midline shifting (p= 0.048) and steroid use (p< 0.001) were higher in the resection group, which also demonstrated greater symptom improvement (p< 0.001). The complication rates were comparable between groups. The 5-year overall survival (OS) was 81.3% (resection) vs. 80.1% (biopsy), and the 5-year progression-free survival (PFS) was 53.6% (resection) vs. 60.3% (biopsy), with no significant differences in OS or PFS by Cox regression analysis.Conclusions:Surgical resection does not improve OS or PFS in solitary, resectable PCNSL, though it may provide symptomatic relief in select cases. Further prospective studies are needed to define its role in PCNSL management.
**背景/目的：** 原发性中枢神经系统淋巴瘤（PCNSL）的治疗传统上优先考虑诊断性活检，而手术切除常被视为次要选择，这主要是由于既往研究中的风险及潜在偏倚，这些研究多纳入深部或多发肿瘤患者。本研究旨在评估手术切除对单发、可切除PCNSL患者生存的影响。 **方法：** 我们对2010年1月至2022年12月期间在本机构通过脑活检或手术切除治疗的PCNSL患者进行了回顾性分析。排除了肿瘤位于深部（胼胝体、基底节、丘脑和脑干）或多发病灶的病例。比较了两组患者的生存情况及临床结局。 **结果：** 共纳入79例患者（30例切除，49例活检）。两组在人口统计学特征、合并症、肿瘤特征或国际结外淋巴瘤研究组评分方面均无显著差异。切除组的术前中线移位（p=0.048）和类固醇使用率（p<0.001）较高，且症状改善更明显（p<0.001）。两组并发症发生率相当。5年总生存率（OS）分别为81.3%（切除组）和80.1%（活检组），5年无进展生存率（PFS）分别为53.6%（切除组）和60.3%（活检组）。Cox回归分析显示，两组在OS或PFS方面均无显著差异。 **结论：** 对于单发、可切除的PCNSL，手术切除并未改善OS或PFS，但在部分病例中可能有助于缓解症状。未来需要进一步的前瞻性研究以明确手术切除在PCNSL治疗中的作用。
肿瘤(癌症)患者之家