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. 2020 Jan 13:2020:9327868.
doi: 10.1155/2020/9327868. eCollection 2020.

Clinicopathological Features, Treatment Strategy, and Prognosis of Primary Non-Hodgkin's Lymphoma of the Duodenum: A SEER Database Analysis

Guoliang Zheng  1 , Yue Wang  1 , Yan Zhao  1 , Zhichao Zheng  1
Affiliations

Clinicopathological Features, Treatment Strategy, and Prognosis of Primary Non-Hodgkin's Lymphoma of the Duodenum: A SEER Database Analysis

Guoliang Zheng et al. Can J Gastroenterol Hepatol. .

Abstract

Objective: Primary duodenum lymphoma (PDL) is extremely rare with limited data available in the literature. In this study, we sought to describe clinical features and identify factors affecting survival in patients with PDL using a large population cohort.

Methods: The Surveillance, Epidemiology, and End Results (SEER) database was queried from 1998 to 2015.

Results: A total of 1060 cases of PDLs were identified. Clinicopathological features as well as survival data of PDLs were analyzed and compared with 10573 primary gastric lymphomas (PGLs) and 3239 primary small intestinal lymphomas (PSILs) from the SEER database. PDL patients were younger in age (60.96 ± 15.205), and the proportion of stage I (53.21%) was higher in Ann Arbor staging. The proportion of PDLs treated by surgery (8.68%) is the lowest among PDLs, PGLs, and PSILs. The DSS of PDLs were significantly better than those of PGLs and PSILs, respectively (10-year survival rate: 21.24% vs. 20.40%, P=0.027; 10-year survival rate: 21.24% vs. 16.79%, P=0.001). Age, gender, Ann Arbor staging, and histological type were regarded as independent prognostic factor for the DSS by multivariate analysis (all P < 0.05). Patients with <65 years, female, stage I, and FL were found to be significantly associated with good DSS. The treatment modality (surgery vs. conservative treatment) was not statistically related to DSS. The proportion of PDL patients who received surgical treatment gradually decreased from 15.60% in period 2 to 5.26% in period 4.

Conclusions: The clinicopathologic features of duodenal lymphoma were significantly different from those of gastric lymphoma and small intestinal lymphoma. The prognosis of PDLs was significantly better than those of the other two groups, and there was no statistical survival benefit from surgery in PDLs.

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Conflict of interest statement

The authors declare that they have no conflicts of interest to this work.

Figures

Figure 1
Figure 1
Comparison of DSS among PDLs, PGLs, and PSILs. The results showed that the DSS of PDLs were significantly better than those of PGLs and PSILs (10-year survival rate: 21.24% vs. 20.40%, P=0.027; 10-year survival rate: 21.24% vs. 16.79%, P=0.001). PDLs vs. PGLs: P < 0.05; PDLs vs. PSILs: P < 0.05. PGL, primary gastric lymphoma; PSIL, primary small intestinal lymphoma; PDL, primary duodenum lymphoma.
Figure 2
Figure 2
The stratified analysis according to (a) age, (b) gender, (c) Ann Arbor staging, and (d) histological type in the PDLs. Patients with <65 years, female, stage I, and FL were found to be significantly associated with good DSS. However, patients with ≥60 years, male, stage IV, and TCL were found to be significantly associated with poor DSS (all P < 0.05).
Figure 3
Figure 3
Trend of treatment modality (surgery vs. conservative treatment) to PGLs over the 18-year period from 1998 to 2015. The proportion of patients who received conservative treatment increased from 84.40% in period 2 to 94.74% in period 4, whereas patients who received surgical treatment gradually decreased from 15.60% in period 2 to 5.26% in period 4.
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