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.
Highlights
E results showed that age, gender, symptom, and histological type were significantly different between Primary duodenum lymphoma (PDL) and primary gastric lymphomas (PGLs); that is, incidence of tumors with younger patients or more follicular lymphoma was significantly higher in the PDL group compared to that in the PGL group. e PDL group showed younger patients, earlier Ann Arbor staging, more follicular lymphoma, and more surgery treatment in comparison with those of the primary small intestinal lymphomas (PSILs) group
To the best of our knowledge, the current study represented the largest number of PDLs
We summarized clinical and pathological features of 1060 cases of PDLs
Summary
1. Introduction e most predominant extranodal site in non-Hodgkin’s lymphoma (NHL) is the gastrointestinal (GI) tract [1], accounting for 5% to 20% of all NHL cases and 30% to 45% of all extranodal cases [2]. As primary duodenum lymphomas (PDLs) are exceedingly rare, the current researches about PDLs are based on anecdotal reports [4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23]. We retrospectively reviewed the clinical and pathological manifestations of lymphomas of duodenum lymphoma for cases based on the largest sample size so far to identify prognostic factors and to clarify the value of treatment modalities in the management of these malignancies
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