The role of surgical intervention in primary colorectal lymphoma: A SEER population-based analysis

Oncotarget. 2016 Nov 1;7(44):72263-72275. doi: 10.18632/oncotarget.12344.

Abstract

Background: Primary colorectal lymphoma (PCL) is a rare colorectal malignancy. The standard treatment and prognostic factors of PCL remain unexplored. Therefore, a large population-based study should be conducted to provide a detailed review of this disease.

Methods: We extracted the data of eligible patients with PCL registered in the SEER database from 1973 to 2011. All statistical analyses were performed using SPSS 19.0.

Results: A total of 2050 (61.3%) of the 3342 patients with PCL underwent surgical intervention, and 1292 (38.7%) patients received no surgical treatment. The median overall survival was 95 months, and patients receiving surgery exhibited significantly prolonged survival (adjusted HR =0.69, P <0.001). Young age, early tumor stage, and indolent lymphoma were independent predictors of improved survival. Further survival analyses demonstrated the potential benefit of surgery in patients with early tumor stage, right-sided lesions, or diffuse large B-cell PCL. Conversely, surgical intervention did not improve the survival of patients with advanced-stage, left-sided, or indolent PCL.

Conclusion: PCL is a rare tumor that can be effectively treated. Surgical intervention may play an important role in the treatment of PCL. Early tumor stage, a right-sided lesion, and diffuse large B-cell histological PCL seem to be the clinical characteristics of optimal surgical candidates.

Keywords: SEER; primary colorectal lymphoma; prognosis; surgical intervention; survival.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols
  • Colorectal Neoplasms / mortality*
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery*
  • Colorectal Surgery / statistics & numerical data
  • Female
  • Humans
  • Lymphoma / mortality*
  • Lymphoma / pathology
  • Lymphoma / surgery*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Patient Selection
  • Prognosis
  • Retrospective Studies
  • SEER Program / statistics & numerical data*
  • Survival Analysis
  • Treatment Outcome