Clinical Characteristics and Survival of Primary Duodenal Lymphoma: Analysis Based on SEER Database / 胃肠病学

ABSTRACT

Background: Primary duodenal lymphoma (PDL) is a rare extranodal malignant lymphoma. Till now, there are insufficient data regarding its clinical characteristics and prognosis. Aims: To analyze the clinical characteristics and prognostic factors of PDL based on SEER database. Methods: Patients diagnosed as PDL between 1975 and 2015 were evaluated via data collected from the SEER database. The demographic, clinical, pathological features and survival time were reviewed. Survival analysis was conducted by using Kaplan-Meier method. Univariate and multivariate Cox regression analyses were applied to identify the survival predictors. Results: A total of 1 659 patients with PDL were enrolled in the study. The median age was 64 years, and the median survival time was 40 months. The overwhelming majority of PDLs were B-cell non-Hodgkin lymphomas (B-NHL), of which, follicular lymphoma (36.0%) and diffuse large B-cell lymphoma (DLBCL; 30.5%) accounting for approximately two thirds of the PDL patients. The 1-, 3-, 5-, and 10-year overall survival rates were 49.2%, 39.0%, 31.4%, and 13.8%, respectively. The prognosis of T-cell non-Hodgkin lymphoma (T-NHL) had a worse survival than B-NHL, and the prognosis of DLBCL was the worst in B-NHL. In multivariate Cox regression analysis, male gender, old age (>65 years), divorced/widowed or unmarried, T-NHL, and advanced clinical stage were identified as the independent risk factors for poor overall and tumor-specific survival in PDL patients, while diagnosed after 1997 (rituximab launch date) was an independent protective factor (all P<0.05). Conclusions: The prognosis of PDL patients is independently correlated with the gender, age, marital status, time of diagnosis, as well as the tumor pathological type and clinical stage. Early diagnosis of DLBCL and T-NHL may prolong the survival time. Immunotherapy such as rituximab may also improve the survival.