Abstract
BackgroundPrimary colorectal lymphoma (PCL) is a rare colorectal malignancy. The standard treatment and prognostic factors of PCL remain unexplored. Therefore, a large population-based study should be conducted to provide a detailed review of this disease.MethodsWe extracted the data of eligible patients with PCL registered in the SEER database from 1973 to 2011. All statistical analyses were performed using SPSS 19.0.ResultsA total of 2050 (61.3%) of the 3342 patients with PCL underwent surgical intervention, and 1292 (38.7%) patients received no surgical treatment. The median overall survival was 95 months, and patients receiving surgery exhibited significantly prolonged survival (adjusted HR =0.69, P <0.001). Young age, early tumor stage, and indolent lymphoma were independent predictors of improved survival. Further survival analyses demonstrated the potential benefit of surgery in patients with early tumor stage, right-sided lesions, or diffuse large B-cell PCL. Conversely, surgical intervention did not improve the survival of patients with advanced-stage, left-sided, or indolent PCL.ConclusionPCL is a rare tumor that can be effectively treated. Surgical intervention may play an important role in the treatment of PCL. Early tumor stage, a right-sided lesion, and diffuse large B-cell histological PCL seem to be the clinical characteristics of optimal surgical candidates.
Highlights
Involvement of extranodal organs is a relatively common clinical finding in Non-Hodgkin lymphoma (NHL), and approximately 25-40% of patients present with primary extranodal lymphoma [1]
Considering the heterogeneous nature of lymphoma, we focused on the five most common histological subtypes (Table 1), which accounted for 76.3% of all patients with Primary colorectal lymphoma (PCL) in the SEER database
Most patients who underwent surgical intervention were diagnosed at stage IIE (P < 0.001), whereas fewer patients were in stage IVE (P < 0.001)
Summary
Involvement of extranodal organs is a relatively common clinical finding in Non-Hodgkin lymphoma (NHL), and approximately 25-40% of patients present with primary extranodal lymphoma [1]. The majority of extranodal involvement, which accounts for 3040%, occurs in the gastrointestinal tract [2,3,4]. Primary colorectal lymphoma (PCL) is an uncommon original site of extranodal NHL that accounts for approximately 10-20% of gastrointestinal NHL [5,6,7] and comprises 0.2-0.6% of large bowel malignancies [8]. The diagnostic criteria of PCL are not standardized because of the rarity of PCL and lack of clinical data. It is difficult to differentiate PCL from typical digestive diseases in adults because of these non-specific clinical symptoms. Primary colorectal lymphoma (PCL) is a rare colorectal malignancy. A large population-based study should be conducted to provide a detailed review of this disease
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