Population Outcomes in Primary Central Nervous System Lymphoma: Provincial Experience and National Survey
Bibliographic record
Abstract
Introduction: Primary central nervous system lymphoma (PCNSL) is rare and carries a poor prognosis. A retrospective review of Manitoba data for patients diagnosed with PCNSL spanning 1998-2008 was undertaken along with a national survey of PCNSL management. The study’s goal was to benchmark provincial metrics for diagnostic work-up and patient outcomes in PCNSL. Materials and Methods: A retrospective chart review was carried out, and data involving diagnostic workup, treatment, and outcome were collected. A mailed survey regarding PCNSL diagnosis and therapeutic practices was distributed to adult neuro oncology centres in Canada. Results: The age adjusted rate of PCNSL in Manitoba was 0.8 cases per 100,000. Comparing diagnostic tests obtained by Manitobans with PCNSL between 1998-2003 and 2004-2008, the proportion of patients receiving the appropriate testings increased. Curative intent treatment utilizing high-dose methotrexate was offered to 12/72 (17%) patients, and conferred a median overall survival (OS) of 33 months. Non-curative intent therapy or palliation was offered to 83% of patients, who achieved a median OS of 2 months. No significant survival difference was found between patients receiving non-curative chemotherapy or radiotherapy. National survey results demonstrate significant variation in the management of patients with PCNSL across Canada. Discussion: The proportion of patients receiving appropriate diagnostic testing has increased over time. Patients considered for non-curative intent therapy have suboptimal responses and may benefit from novel treatment approaches or more aggressive palliation. National variation in PCNSL management offers an opportunity to develop a national consensus.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".