Clinical and prognostic factors guiding diagnosis and treatment of prostate diffuse large B-cell lymphoma

The objective of this study is to evaluate the clinical presentations, treatment strategies, and prognostic factors for prostate diffuse large B-cell lymphoma (DLBCL), aiming to improve patient management and outcomes. We conducted a retrospective analysis of four prostate DLBCL cases treated at Beijing Chaoyang Hospital between 2014 and 2024, integrating these findings with data from the surveillance, epidemiology, and end results (SEER) dataset (2000–2021) to provide a broader context. All four patients underwent thorough diagnostic evaluations, and immunohistochemistry (IHC) confirmed their diagnoses. Kaplan-Meier survival curves and Cox regression analysis were applied to the SEER dataset to assess overall survival and treatment efficacy. P-values below 0.05 considered statistically significant. All four patients were diagnosed with prostate DLBCL via biopsy and confirmed by IHC, with extraprostatic involvement in three cases. Two patients achieved complete response, and one had partial response. In the SEER database, Kaplan-Meir analysis found that 59 patients had a 5-year survival rate of 59 months when it dropped in half, while multi-variable Cox regression highlighted age (HR 10.45, p < 0.001), surgery (HR 0.38, p = 0.0292), and radiation (HR 0.35, p = 0.0212) as the survival predictors. Although chemotherapy was administered in clinical practice, its impact was not statistically significant in our analysis. Prostate DLBCL is aggressive with diverse clinical presentations, making early detection and personalized treatment essential. Surgery and radiotherapy significantly improve patient outcomes, but the prognostic impact of chemotherapy, despite its widespread use, requires further validation through clinical trials.