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Surgery does not adversely affect survival in primary gastrointestinal lymphoma
Author(s) -
Cheung Michael C.,
Housri Nadine,
Ogilvie Michael P.,
Sola Juan E.,
Koniaris Leonidas G.
Publication year - 2009
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21298
Subject(s) - medicine , perforation , lymphoma , incidence (geometry) , multivariate analysis , surgery , univariate analysis , epidemiology , hazard ratio , survival analysis , gastroenterology , confidence interval , punching , metallurgy , materials science , physics , optics
Objective To evaluate the impact of surgery on gastrointestinal lymphoma. Methods The Surveillance, Epidemiology, and End Results (SEER) database was queried from 1973 to 2005. Results A total of 17,222 cases of PGIL were identified. The overall incidence of PGIL was approximately 1.505 cases per 100,000. A significantly increasing incidence for PGIL was observed (APC = +4.67, P < 0.05). In the cases for which treatment data was available, resection occurred in roughly half of the patients. In univariate analysis, surgical extirpation did not improve survival (47 months vs. 76 months, P < 0.001), while radiation treatment improved median survival (77 months vs. 59 months, P < 0.001). Multivariate analysis revealed increasing age and male gender as independent predictors of decreased overall survival. Tumor location also was a significant predictor of outcome. Large B‐cell lymphoma type PGIL had a poorer prognosis than marginal zone B‐cell lymphoma. By multivariate analysis, surgery was not found to increase the risk of death (HR = 0.99). Conclusions No associated survival benefit for surgery in the treatment in gastrointestinal lymphoma was observed. Determination of lymphoma should preclude surgical resection. Nonetheless, inadvertent extirpative surgery or in association with perforation does not appear to increase mortality. J. Surg. Oncol. 2009;100:59–64. © 2009 Wiley‐Liss, Inc.