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Published in: Journal of Gastrointestinal Surgery 6/2016

01-06-2016 | Original Article

Management of Primary Gastrointestinal Non-Hodgkin Lymphomas: a Population-Based Survival Analysis

Authors: Evan Michael Shannon, Ian T. MacQueen, Jeffrey M. Miller, Melinda Maggard-Gibbons

Published in: Journal of Gastrointestinal Surgery | Issue 6/2016

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Abstract

Introduction

Primary gastrointestinal non-Hodgkin lymphomas (PGINHL) are a heterogeneous group of rare GI malignancies with limited data to guide management. This study describes management of PGINHL in a population-based registry and aims to determine the association between receipt of surgery and long-term survival.

Methods

All adults diagnosed with PGINHL over 27 years in the Surveillance, Epidemiology, and End Results were identified (excluding mucosa-associated lymphoid tissue lymphomas). Demographic and clinical characteristics were assessed. Survival was compared using the log-rank method. Cox hazard modeling was used to determine independent prognostic factors.

Results

We identified 16,129 patients. The majority were of gastric origin and had diffuse large B cell histology. Surgery was performed in 46.9 % of patients, not recommended in 41.8 % and recommended but not performed in 10.1 %. Overall 1-year and 5-year survival rates were 65.6 and 35.6 %, respectively. Patients undergoing surgery had a 5-year survival of 43.6 % compared to 34.8 % for whom surgery was recommended but not performed (p < .0001), (receipt of chemotherapy not available). Female gender, gastric location, follicular or mantle cell histology, and radiation therapy were associated with improved survival.

Conclusions

Nearly 50 % of PGINHL patients underwent surgery. Surgery was not associated with improved survival. More prospective, case-matched studies are needed to guide management.
Literature
1.
go back to reference Hawkes EA, Wotherspoon A, Cunningham D. Diagnosis and management of rare gastrointestinal lymphomas. Leuk Lymphoma. Dec 2012;53(12):2341–2350. Hawkes EA, Wotherspoon A, Cunningham D. Diagnosis and management of rare gastrointestinal lymphomas. Leuk Lymphoma. Dec 2012;53(12):2341–2350.
2.
go back to reference Dawson PJ, Harrison CV. A clinicopathological study of benign Hodgkin’s disease. J Clin Pathol. May 1961;14:219–231. Dawson PJ, Harrison CV. A clinicopathological study of benign Hodgkin’s disease. J Clin Pathol. May 1961;14:219–231.
3.
go back to reference Al-Akwaa AM, Siddiqui N, Al-Mofleh IA. Primary gastric lymphoma. World J Gastroenterol. Jan 2004;10(1):5–11. Al-Akwaa AM, Siddiqui N, Al-Mofleh IA. Primary gastric lymphoma. World J Gastroenterol. Jan 2004;10(1):5–11.
4.
go back to reference Ghimire P, Wu GY, Zhu L. Primary gastrointestinal lymphoma. World J Gastroenterol. Feb 14 2011;17(6):697–707. Ghimire P, Wu GY, Zhu L. Primary gastrointestinal lymphoma. World J Gastroenterol. Feb 14 2011;17(6):697–707.
5.
go back to reference Lewin KJ, Ranchod M, Dorfman RF. Lymphomas of the gastrointestinal tract: a study of 117 cases presenting with gastrointestinal disease. Cancer. Aug 1978;42(2):693–707. Lewin KJ, Ranchod M, Dorfman RF. Lymphomas of the gastrointestinal tract: a study of 117 cases presenting with gastrointestinal disease. Cancer. Aug 1978;42(2):693–707.
6.
go back to reference Cheung MC, Housri N, Ogilvie MP, Sola JE, Koniaris LG. Surgery does not adversely affect survival in primary gastrointestinal lymphoma. J Surg Oncol. Jul 1 2009;100(1):59–64. Cheung MC, Housri N, Ogilvie MP, Sola JE, Koniaris LG. Surgery does not adversely affect survival in primary gastrointestinal lymphoma. J Surg Oncol. Jul 1 2009;100(1):59–64.
7.
go back to reference Gurney KA, Cartwright RA. Increasing incidence and descriptive epidemiology of extranodal non-Hodgkin lymphoma in parts of England and Wales. Hematol J. 2002;3(2):95–104.CrossRefPubMed Gurney KA, Cartwright RA. Increasing incidence and descriptive epidemiology of extranodal non-Hodgkin lymphoma in parts of England and Wales. Hematol J. 2002;3(2):95–104.CrossRefPubMed
8.
go back to reference Halme L, Mecklin JP, Juhola M, Krees R, Palmu A. Primary gastrointestinal non-Hodgkin’s lymphoma. A population based study in central Finland in 1975–1993. Acta oncologica. 1997;36(1):69–74.CrossRefPubMed Halme L, Mecklin JP, Juhola M, Krees R, Palmu A. Primary gastrointestinal non-Hodgkin’s lymphoma. A population based study in central Finland in 1975–1993. Acta oncologica. 1997;36(1):69–74.CrossRefPubMed
9.
go back to reference Stathis A, Chini C, Bertoni F, et al. Long-term outcome following Helicobacter pylori eradication in a retrospective study of 105 patients with localized gastric marginal zone B-cell lymphoma of MALT type. Ann Oncol. Jun 2009;20(6):1086–1093. Stathis A, Chini C, Bertoni F, et al. Long-term outcome following Helicobacter pylori eradication in a retrospective study of 105 patients with localized gastric marginal zone B-cell lymphoma of MALT type. Ann Oncol. Jun 2009;20(6):1086–1093.
10.
go back to reference Stolte M, Bayerdorffer E, Morgner A, et al. Helicobacter and gastric MALT lymphoma. Gut. May 2002;50 Suppl 3:III19-24. Stolte M, Bayerdorffer E, Morgner A, et al. Helicobacter and gastric MALT lymphoma. Gut. May 2002;50 Suppl 3:III19-24.
11.
go back to reference Atalay C, Kanlioz M, Demir S, Pak I, Altinok M. Primary gastrointestinal tract lymphomas. Acta chirurgica Belgica. Nov-Dec 2003;103(6):616–620. Atalay C, Kanlioz M, Demir S, Pak I, Altinok M. Primary gastrointestinal tract lymphomas. Acta chirurgica Belgica. Nov-Dec 2003;103(6):616–620.
12.
go back to reference Fischbach W, Dragosics B, Kolve-Goebeler ME, et al. Primary gastric B-cell lymphoma: results of a prospective multicenter study. The German-Austrian Gastrointestinal Lymphoma Study Group. Gastroenterol. Nov 2000;119(5):1191–1202. Fischbach W, Dragosics B, Kolve-Goebeler ME, et al. Primary gastric B-cell lymphoma: results of a prospective multicenter study. The German-Austrian Gastrointestinal Lymphoma Study Group. Gastroenterol. Nov 2000;119(5):1191–1202.
13.
go back to reference Daum S, Ullrich R, Heise W, et al. Intestinal non-Hodgkin’s lymphoma: a multicenter prospective clinical study from the German Study Group on Intestinal non-Hodgkin’s Lymphoma. J Clin Oncol. Jul 15 2003;21(14):2740–2746. Daum S, Ullrich R, Heise W, et al. Intestinal non-Hodgkin’s lymphoma: a multicenter prospective clinical study from the German Study Group on Intestinal non-Hodgkin’s Lymphoma. J Clin Oncol. Jul 15 2003;21(14):2740–2746.
14.
go back to reference Erkurt MA, Aydogdu I, Kuku I, Kaya E, Mizrak B, Basaran Y. A multicentric, hyaline vascular variant of Castleman’s disease associated with B cell lymphoma: a case report. Cases J. 2009;2:8183.CrossRefPubMedPubMedCentral Erkurt MA, Aydogdu I, Kuku I, Kaya E, Mizrak B, Basaran Y. A multicentric, hyaline vascular variant of Castleman’s disease associated with B cell lymphoma: a case report. Cases J. 2009;2:8183.CrossRefPubMedPubMedCentral
15.
go back to reference Eser B, Kaplan B, Unal A, et al. Clinicopathologic characteristics and therapeutic outcomes of primary gastrointestinal non-Hodgkin’s lymphomas in central Anatolia, in Turkey. Yonsei Med J. Feb 28 2006;47(1):22–33. Eser B, Kaplan B, Unal A, et al. Clinicopathologic characteristics and therapeutic outcomes of primary gastrointestinal non-Hodgkin’s lymphomas in central Anatolia, in Turkey. Yonsei Med J. Feb 28 2006;47(1):22–33.
16.
go back to reference Kim SJ, Kang HJ, Kim JS, et al. Comparison of treatment strategies for patients with intestinal diffuse large B-cell lymphoma: surgical resection followed by chemotherapy versus chemotherapy alone. Blood. Feb 10 2011;117(6):1958–1965. Kim SJ, Kang HJ, Kim JS, et al. Comparison of treatment strategies for patients with intestinal diffuse large B-cell lymphoma: surgical resection followed by chemotherapy versus chemotherapy alone. Blood. Feb 10 2011;117(6):1958–1965.
17.
go back to reference Lai YL, Lin JK, Liang WY, Huang YC, Chang SC. Surgical resection combined with chemotherapy can help achieve better outcomes in patients with primary colonic lymphoma. J Surg Oncol. Sep 1 2011;104(3):265–268. Lai YL, Lin JK, Liang WY, Huang YC, Chang SC. Surgical resection combined with chemotherapy can help achieve better outcomes in patients with primary colonic lymphoma. J Surg Oncol. Sep 1 2011;104(3):265–268.
18.
go back to reference Lee HS, Park LC, Lee EM, et al. Comparison of Therapeutic Outcomes Between Surgical Resection Followed By R-CHOP and R-CHOP Alone for Localized Primary Intestinal Diffuse Large B-cell Lymphoma. Am J Clin Oncol. Dec 1 2012. Lee HS, Park LC, Lee EM, et al. Comparison of Therapeutic Outcomes Between Surgical Resection Followed By R-CHOP and R-CHOP Alone for Localized Primary Intestinal Diffuse Large B-cell Lymphoma. Am J Clin Oncol. Dec 1 2012.
19.
go back to reference Tang TC, Kuo MC, Chang H, et al. Primary colonic lymphoma: an analysis of 74 cases with localized large-cell lymphoma. Eur J Haematol. Jul 2011;87(1):28–36. Tang TC, Kuo MC, Chang H, et al. Primary colonic lymphoma: an analysis of 74 cases with localized large-cell lymphoma. Eur J Haematol. Jul 2011;87(1):28–36.
20.
go back to reference Cirocchi R, Farinella E, Trastulli S, et al. Surgical treatment of primitive gastro-intestinal lymphomas: a systematic review. World J Surg Oncol. 2011;9:145.CrossRefPubMedPubMedCentral Cirocchi R, Farinella E, Trastulli S, et al. Surgical treatment of primitive gastro-intestinal lymphomas: a systematic review. World J Surg Oncol. 2011;9:145.CrossRefPubMedPubMedCentral
21.
go back to reference Fischbach W, Schramm S, Goebeler E. Outcome and quality of life favour a conservative treatment of patients with primary gastric lymphoma. Zeitschrift fur Gastroenterologie. Apr 2011;49(4):430–435. Fischbach W, Schramm S, Goebeler E. Outcome and quality of life favour a conservative treatment of patients with primary gastric lymphoma. Zeitschrift fur Gastroenterologie. Apr 2011;49(4):430–435.
22.
go back to reference Willich NA, Reinartz G, Horst EJ, et al. Operative and conservative management of primary gastric lymphoma: interim results of a German multicenter study. Int J Radiat Oncol Biol Phys. Mar 1 2000;46(4):895–901. Willich NA, Reinartz G, Horst EJ, et al. Operative and conservative management of primary gastric lymphoma: interim results of a German multicenter study. Int J Radiat Oncol Biol Phys. Mar 1 2000;46(4):895–901.
23.
go back to reference Aviles A, Nambo MJ, Neri N, et al. The role of surgery in primary gastric lymphoma: results of a controlled clinical trial. Annals of surgery. Jul 2004;240(1):44–50. Aviles A, Nambo MJ, Neri N, et al. The role of surgery in primary gastric lymphoma: results of a controlled clinical trial. Annals of surgery. Jul 2004;240(1):44–50.
24.
go back to reference Beaton C, Davies M, Beynon J. The management of primary small bowel and colon lymphoma--a review. Int J Colorectal Dis. May 2012;27(5):555–563. Beaton C, Davies M, Beynon J. The management of primary small bowel and colon lymphoma--a review. Int J Colorectal Dis. May 2012;27(5):555–563.
25.
go back to reference Kim SJ, Choi CW, Mun YC, et al. Multicenter retrospective analysis of 581 patients with primary intestinal non-hodgkin lymphoma from the Consortium for Improving Survival of Lymphoma (CISL). BMC cancer. 2011;11:321.CrossRefPubMedPubMedCentral Kim SJ, Choi CW, Mun YC, et al. Multicenter retrospective analysis of 581 patients with primary intestinal non-hodgkin lymphoma from the Consortium for Improving Survival of Lymphoma (CISL). BMC cancer. 2011;11:321.CrossRefPubMedPubMedCentral
26.
go back to reference Lee J, Kim WS, Kim K, et al. Intestinal Lymphoma: Exploration of the Prognostic Factors and the Optimal Treatment. Leuk lymphoma. 2004;45(2):339–344.CrossRefPubMed Lee J, Kim WS, Kim K, et al. Intestinal Lymphoma: Exploration of the Prognostic Factors and the Optimal Treatment. Leuk lymphoma. 2004;45(2):339–344.CrossRefPubMed
27.
go back to reference Castillo JJ, Winer ES, Olszewski AJ. Sites of extranodal involvement are prognostic in patients with diffuse large B-cell lymphoma in the rituximab era: an analysis of the Surveillance, Epidemiology and End Results database. Am J Hematol. Mar 2014;89(3):310–314. Castillo JJ, Winer ES, Olszewski AJ. Sites of extranodal involvement are prognostic in patients with diffuse large B-cell lymphoma in the rituximab era: an analysis of the Surveillance, Epidemiology and End Results database. Am J Hematol. Mar 2014;89(3):310–314.
28.
go back to reference Kassira N, Pedroso FE, Cheung MC, Koniaris LG, Sola JE. Primary gastrointestinal tract lymphoma in the pediatric patient: review of 265 patients from the SEER registry. J Pediatr Surg. Oct 2011;46(10):1956–1964. Kassira N, Pedroso FE, Cheung MC, Koniaris LG, Sola JE. Primary gastrointestinal tract lymphoma in the pediatric patient: review of 265 patients from the SEER registry. J Pediatr Surg. Oct 2011;46(10):1956–1964.
29.
go back to reference Shchepotin IB, Evans SR, Shabahang M, et al. Primary non-Hodgkin’s lymphoma of the stomach: three radical modalities of treatment in 75 patients. Ann Surg Oncol. May 1996;3(3):277–284. Shchepotin IB, Evans SR, Shabahang M, et al. Primary non-Hodgkin’s lymphoma of the stomach: three radical modalities of treatment in 75 patients. Ann Surg Oncol. May 1996;3(3):277–284.
30.
go back to reference Ambinder AJ, Shenoy PJ, Nastoupil LJ, Flowers CR. Using primary site as a predictor of survival in mantle cell lymphoma. Cancer. Apr 15 2013;119(8):1570–1577. Ambinder AJ, Shenoy PJ, Nastoupil LJ, Flowers CR. Using primary site as a predictor of survival in mantle cell lymphoma. Cancer. Apr 15 2013;119(8):1570–1577.
31.
go back to reference Campo E, Swerdlow SH, Harris NL, Pileri S, Stein H, Jaffe ES. The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications. Blood. May 12 2011;117(19):5019–5032. Campo E, Swerdlow SH, Harris NL, Pileri S, Stein H, Jaffe ES. The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications. Blood. May 12 2011;117(19):5019–5032.
32.
go back to reference Coiffier B, Lepage E, Briere J, et al. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. New Engl J Med. Jan 24 2002;346(4):235–242. Coiffier B, Lepage E, Briere J, et al. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. New Engl J Med. Jan 24 2002;346(4):235–242.
33.
go back to reference Plosker GL, Figgitt DP. Rituximab: a review of its use in non-Hodgkin’s lymphoma and chronic lymphocytic leukaemia. Drugs. 2003;63(8):803–843.CrossRefPubMed Plosker GL, Figgitt DP. Rituximab: a review of its use in non-Hodgkin’s lymphoma and chronic lymphocytic leukaemia. Drugs. 2003;63(8):803–843.CrossRefPubMed
34.
go back to reference Hermans J, Krol AD, van Groningen K, et al. International Prognostic Index for aggressive non-Hodgkin’s lymphoma is valid for all malignancy grades. Blood. Aug 15 1995;86(4):1460–1463. Hermans J, Krol AD, van Groningen K, et al. International Prognostic Index for aggressive non-Hodgkin’s lymphoma is valid for all malignancy grades. Blood. Aug 15 1995;86(4):1460–1463.
35.
go back to reference A predictive model for aggressive non-Hodgkin’s lymphoma. The International Non-Hodgkin’s Lymphoma Prognostic Factors Project. New Engl J Med. Sep 30 1993;329(14):987–994. A predictive model for aggressive non-Hodgkin’s lymphoma. The International Non-Hodgkin’s Lymphoma Prognostic Factors Project. New Engl J Med. Sep 30 1993;329(14):987–994.
Metadata
Title
Management of Primary Gastrointestinal Non-Hodgkin Lymphomas: a Population-Based Survival Analysis
Authors
Evan Michael Shannon
Ian T. MacQueen
Jeffrey M. Miller
Melinda Maggard-Gibbons
Publication date
01-06-2016
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 6/2016
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-016-3129-8

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