Primary Gastrointestinal Lymphoma: A Retrospective Cohort Study on Clinical Presentation, Treatment Outcomes, and Survival Trends With a Focus on Emergency Versus Elective Management

IF 1.5 Q3 GASTROENTEROLOGY & HEPATOLOGY

JGH Open Pub Date : 2025-09-26 DOI:10.1002/jgh3.70283

Thamir Alshamari, Priscilla Chong, Lau Min Yi, Diviya Pergassam, Dhanushan Gnanendran

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Abstract

Purpose

Primary gastrointestinal lymphoma (PGIL) is a rare cancer, with diffuse large B-cell lymphoma (DLBCL) as the most common subtype. PGIL can be acute, requiring emergency surgery, or non-acute, allowing elective management. This article evaluates the clinical presentation, treatments, and survival outcomes of PGIL by comparing emergency and elective cases.

Methods

A retrospective cohort study from January 2013 to December 2019 included patients with histologically confirmed PGIL, excluding secondary GI involvement. Survival distributions were performed using SPSS v.20 and Kaplan–Meier analysis.

Results

Among 33 patients, 54.5% were male, with a mean age of 69. The most common site of lymphoma was the small bowel (54.5%), with DLBCL being the predominant subtype (66.7%). Emergency cases comprised 57.6% of the cohort. Poorer survival was noted in emergency cases, with significant differences in survival by age (p = 0.036) and lymphoma site (p = 0.038). Surgical excision was the main diagnostic method in emergency cases (54.5%), while endoscopic biopsy was more common in elective cases (39.4%) (p < 0.001). Chemotherapy was given to 69.7%, with R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, Prednisone) (65.2%) being the most used regimen. Median survival was 17 months (interquartile range, IQR: 10–44.5). Survival differences were significant by age (p = 0.036) and lymphoma site (p = 0.038).

Conclusion

Emergency surgery is often needed for PGIL, especially with small bowel lymphomas, which have poorer outcomes. Early diagnosis and elective care may improve prognosis. Further research should explore prognostic markers and standardize treatment.

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原发性胃肠道淋巴瘤：临床表现、治疗结果和生存趋势的回顾性队列研究，重点是急诊与选择性治疗

目的原发性胃肠道淋巴瘤（PGIL）是一种罕见的肿瘤，弥漫大b细胞淋巴瘤（DLBCL）是最常见的亚型。PGIL可以是急性的，需要紧急手术，也可以是非急性的，允许择期治疗。本文通过比较急诊和择期病例来评估PGIL的临床表现、治疗和生存结果。方法2013年1月至2019年12月的回顾性队列研究纳入了组织学证实的PGIL患者，不包括继发性胃肠道受累。生存分布采用SPSS v.20和Kaplan-Meier分析。结果33例患者中，男性占54.5%，平均年龄69岁。最常见的淋巴瘤部位为小肠（54.5%），以DLBCL为主要亚型（66.7%）。急诊病例占该队列的57.6%。急诊病例的生存率较低，不同年龄（p = 0.036）和淋巴瘤部位（p = 0.038）的生存率存在显著差异。急诊病例以手术切除为主（54.5%），择期病例以内镜活检为主（39.4%）（p < 0.001）。化疗占69.7%，其中R-CHOP方案（利妥昔单抗、环磷酰胺、阿霉素、长春新碱、强的松）占65.2%。中位生存期为17个月（四分位间距，IQR: 10-44.5）。年龄（p = 0.036）和淋巴瘤部位（p = 0.038）的生存率差异有统计学意义。结论PGIL常需急诊手术治疗，尤其是小肠淋巴瘤，其预后较差。早期诊断和选择性护理可改善预后。进一步的研究应探索预后标志物和规范治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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