The prognostic impact of lymphoma perforation in patients with primary gastrointestinal lymphoma – a single-center analysis

Patients with primary gastrointestinal (GI) lymphoma are at risk of GI perforations. Therefore, we aimed to investigate the prognostic impact of non-traumatic GI perforations. 54 patients with a histologically confirmed diagnosis of primary GI lymphoma were included. Non-traumatic lymphoma perforation occurred in ten patients (19%). Perforations occurred only in patients with aggressive B-cell lymphoma. In patients with aggressive B-cell lymphoma, the median overall survival (mOS) was 52 months (95% CI 9.88-94.12) and 27 months (95% CI 0.00-135.48) in patients with and without GI perforation, respectively. The median progression-free survival (mPFS) was 30 months (95% CI 5.6-54.4) in patients with GI perforations. In patients without lymphoma perforation, mPFS was not reached. Both mOS and mPFS did not significantly differ. In conclusion, despite the need for emergency surgery and delay in lymphoma-directed treatment, lymphoma perforation did not negatively impact our study population's OS or PFS.

[1]  L. Zhai,et al.  The impact of surgery on long-term survival of patients with primary intestinal non-Hodgkin lymphomas based on SEER database , 2021, Scientific Reports.

[2]  Yuankai Shi,et al.  R‐CHOP immunochemotherapy plus surgery is associated with a superior prognosis in Chinese primary intestinal diffuse large B‐cell lymphoma , 2020, Asia-Pacific journal of clinical oncology.

[3]  Weili Zhao,et al.  Localized primary gastrointestinal diffuse large B cell lymphoma received a surgical approach: an analysis of prognostic factors and comparison of staging systems in 101 patients from a single institution , 2015, World Journal of Surgical Oncology.

[4]  T. Habermann,et al.  Bowel perforation in intestinal lymphoma: incidence and clinical features. , 2013, Annals of oncology : official journal of the European Society for Medical Oncology.

[5]  Suresh C. Sharma,et al.  A Retrospective Analysis of Clinicopathological Characteristics, Treatment, and Outcome of 27 Patients of Primary Intestinal Lymphomas , 2013, Journal of Gastrointestinal Cancer.

[6]  J. Zang,et al.  Clinical prognostic analysis of 116 patients with primary intestinal non-Hodgkin lymphoma , 2012, Medical Oncology.

[7]  J. H. Lee,et al.  Multicenter retrospective analysis of 581 patients with primary intestinal non-hodgkin lymphoma from the Consortium for Improving Survival of Lymphoma (CISL) , 2011, BMC Cancer.

[8]  Jinny Park,et al.  Comparison of treatment strategies for patients with intestinal diffuse large B-cell lymphoma: surgical resection followed by chemotherapy versus chemotherapy alone. , 2011, Blood.

[9]  R. Xu,et al.  Primary gastric non-Hodgkin's lymphoma in Chinese patients: clinical characteristics and prognostic factors , 2010, BMC Cancer.

[10]  Y. Oki,et al.  Primary gastric diffuse large B‐cell Lymphoma (DLBCL): analyses of prognostic factors and value of pretreatment FDG‐PET scan , 2010, European journal of haematology.

[11]  A. Shamseddine,et al.  Primary colorectal lymphoma , 2010, Medical oncology.

[12]  Xiao-Cheng Wu,et al.  Incidence of extranodal non-Hodgkin lymphomas among whites, blacks, and Asians/Pacific Islanders in the United States: anatomic site and histology differences. , 2009, Cancer epidemiology.

[13]  H. Nakasone,et al.  Clinical outcome in patients with small intestinal non-Hodgkin lymphoma , 2009, Leukemia & lymphoma.

[14]  A. Psyrri,et al.  Primary extranodal lymphomas of stomach: clinical presentation, diagnostic pitfalls and management. , 2008, Annals of oncology : official journal of the European Society for Medical Oncology.

[15]  M. Du,et al.  Perforation predicts poor prognosis in patients with primary intestinal diffuse large B‐cell lymphoma , 2008, Histopathology.

[16]  P. Liu,et al.  Primary non-Hodgkin lymphomas in the small and large intestine: clinicopathological characteristics and management of 40 patients , 2008, International journal of hematology.

[17]  H. Medina-Franco,et al.  Prognostic Factors in Primary Gastric Lymphoma , 2007, Annals of Surgical Oncology.

[18]  W. Lee,et al.  Prospective clinical study of surgical resection followed by CHOP in localized intestinal diffuse large B cell lymphoma. , 2007, Leukemia research.

[19]  M. Dimopoulos,et al.  Primary gastrointestinal non-Hodgkin's lymphoma: A clinicopathologic study of 128 cases in Greece. A Hellenic Cooperative Oncology Group study (HeCOG) , 2006, Leukemia & lymphoma.

[20]  A. Norman,et al.  Chemotherapy for primary gastric lymphoma: does in-patient observation prevent complications? , 2004, Clinical oncology (Royal College of Radiologists (Great Britain)).

[21]  Joon-Oh Park,et al.  Intestinal Lymphoma: Exploration of the Prognostic Factors and the Optimal Treatment , 2004, Leukemia and Lymphoma.

[22]  É. Lepage,et al.  Surgical resection plus chemotherapy versus chemotherapy alone: comparison of two strategies to treat diffuse large B-cell gastric lymphoma. , 2003, Annals of oncology : official journal of the European Society for Medical Oncology.

[23]  M. Tsuneyoshi,et al.  Primary gastrointestinal lymphoma in Japan , 2003, Cancer.

[24]  A. Avilés,et al.  Combined therapy in the treatment of primary mediastinal B-cell lymphoma: conventional versus escalated chemotherapy , 2002, Annals of Hematology.

[25]  H. Müller-Hermelink,et al.  Primary gastric B-cell lymphoma: results of a prospective multicenter study. The German-Austrian Gastrointestinal Lymphoma Study Group. , 2000, Gastroenterology.

[26]  G. Bonadonna,et al.  Initial chemotherapy for primary resectable large-cell lymphoma of the stomach. , 1997, Annals of oncology : official journal of the European Society for Medical Oncology.

[27]  M. Amer,et al.  Gastrointestinal lymphoma in adults: clinical features and management of 300 cases. , 1994, Gastroenterology.

[28]  N. Brousse,et al.  Primary digestive tract lymphoma: a prospective multicentric study of 91 patients. Groupe d'Etude des Lymphomes Digestifs. , 1993, Gastroenterology.

[29]  A. Santoro,et al.  Combined modality treatment for primary gastrointestinal non-Hodgkin's lymphoma: the Milan Cancer Institute experience. , 1993, Annals of oncology : official journal of the European Society for Medical Oncology.

[30]  K. Maclennan,et al.  Primary gastrointestinal non-Hodgkin's lymphoma: a review of 175 British National Lymphoma Investigation cases. , 1993, British Journal of Cancer.

[31]  S. Erekul,et al.  Primary gastrointestinal lymphomas in Turkey: A retrospective analysis of clinical features and results of treatment , 1992, Journal of surgical oncology.

[32]  M. Talamonti,et al.  Gastrointestinal Lymphoma: A Case for Primary Surgical Resection , 1990 .

[33]  N. Shepherd,et al.  Primary malignant lymphoma of the colon and rectum. A histopathological and immunohistochemical analysis of 45 cases with clinicopathological correlations , 1988, Histopathology.

[34]  T. Economopoulos,et al.  Primary gastric lymphoma--the experience of a general hospital. , 1985, British Journal of Cancer.

[35]  I. Dawson,et al.  Primary malignant lymphoid tumours of the intestinal tract. Report of 37 cases with a study of factors influencing prognosis , 1961, The British journal of surgery.

[36]  E. Zucca,et al.  Primary intestinal diffuse large B-cell non-Hodgkin's lymphoma: clinical features, management, and prognosis of 66 patients. , 2001, Annals of oncology : official journal of the European Society for Medical Oncology.

[37]  N. Willich,et al.  Operative and conservative management of primary gastric lymphoma: interim results of a German multicenter study. , 2000, International journal of radiation oncology, biology, physics.

[38]  J. Faivre,et al.  A 15-year series of gastrointestinal non-Hodgkin's lymphomas: a population-based study. , 1998, British Journal of Cancer.

[39]  C. Jose,et al.  Primary small intestinal lymphoma. , 1992, Oncology.

[40]  G. Salles,et al.  Aggressive primary gastrointestinal lymphomas: review of 91 patients treated with the LNH-84 regimen. A study of the Groupe d'Etude des Lymphomes Agressifs. , 1991, The American journal of medicine.

[41]  F. Ampil Primary gastrointestinal lymphoma. , 1987, Oncology.

[42]  K. Aozasa,et al.  Primary gastrointestinal lymphoma. A clinicopathologic study of 102 patients. , 1985, Oncology.