Surgical Management of Small Bowel Lymphoma
Background Primary small bowel non-Hodgkin’s lymphoma is a rare disease representing 2% of small intestine malignancies. There is limited data delineating the optimal treatment for these heterogeneous tumors. We aim to examine relationships between different treatment modalities and surgical outcome...
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| Veröffentlicht in: | Journal of gastrointestinal surgery 2021-03, Vol.25 (3), p.757-765 |
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| container_title | Journal of gastrointestinal surgery |
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| creator | Lu, Pamela W. Fields, Adam C. Yoo, James Irani, Jennifer Goldberg, Joel E. Bleday, Ronald Melnitchouk, Nelya |
| description | Background
Primary small bowel non-Hodgkin’s lymphoma is a rare disease representing 2% of small intestine malignancies. There is limited data delineating the optimal treatment for these heterogeneous tumors. We aim to examine relationships between different treatment modalities and surgical outcomes in patients with small bowel lymphoma.
Materials and Methods
Patients diagnosed with stage I–III small bowel lymphoma in 2004–2015 who underwent surgery were identified in the National Cancer Database. Two cohorts were created based on systemic chemotherapy treatment status. The primary outcome was overall survival. An adjusted Cox proportional hazards model was used to evaluate the impact of treatment strategy on survival.
Results
2283 patients met inclusion criteria Of these patients, 826 patients (36%) underwent surgical resection alone, and 1457 patients (64%) underwent resection with systemic chemotherapy. Chemotherapy was associated with improved overall survival in unadjusted (5-year overall survival, 55% versus 70%) and adjusted analysis (HR 0.54, 95% CI 0.47–0.63,
p
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| doi_str_mv | 10.1007/s11605-020-04730-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2424097580</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2498796750</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-ae022689bb51768697050853734f280bc51d051cb3258f815a6bb3d5ce5fd0a53</originalsourceid><addsrcrecordid>eNp9kE1LAzEQhoMotlb_gAdZ8CJIdJJsvo5a_IKKhyp4C9ndbG3Zj5p0kf57U7cqePA0A_PMO8OD0DGBCwIgLwMhAjgGChhSyQCzHTQkSjKcCip2Yw-aYMr56wAdhLAAIBKI2kcDRoUQqdZDdD7t_Gye2yp5tI2dudo1q6Qtk2ltqyq5bj9clUzW9fKtre0h2ittFdzRto7Qy-3N8_geT57uHsZXE5wzyVfYOqBUKJ1lnEihhJbAQXEmWVpSBVnOSQGc5BmjXJWKcCuyjBU8d7wswHI2Qmd97tK3750LK1PPQ-6qyjau7YKhKU1BS64goqd_0EXb-SZ-FymtpBaSbyjaU7lvQ_CuNEs_r61fGwJmo9L0Kk1Uab5UGhaXTrbRXVa74mfl210EWA-EOGpmzv_e_if2E-A1e0o</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2498796750</pqid></control><display><type>article</type><title>Surgical Management of Small Bowel Lymphoma</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Lu, Pamela W. ; Fields, Adam C. ; Yoo, James ; Irani, Jennifer ; Goldberg, Joel E. ; Bleday, Ronald ; Melnitchouk, Nelya</creator><creatorcontrib>Lu, Pamela W. ; Fields, Adam C. ; Yoo, James ; Irani, Jennifer ; Goldberg, Joel E. ; Bleday, Ronald ; Melnitchouk, Nelya</creatorcontrib><description>Background
Primary small bowel non-Hodgkin’s lymphoma is a rare disease representing 2% of small intestine malignancies. There is limited data delineating the optimal treatment for these heterogeneous tumors. We aim to examine relationships between different treatment modalities and surgical outcomes in patients with small bowel lymphoma.
Materials and Methods
Patients diagnosed with stage I–III small bowel lymphoma in 2004–2015 who underwent surgery were identified in the National Cancer Database. Two cohorts were created based on systemic chemotherapy treatment status. The primary outcome was overall survival. An adjusted Cox proportional hazards model was used to evaluate the impact of treatment strategy on survival.
Results
2283 patients met inclusion criteria Of these patients, 826 patients (36%) underwent surgical resection alone, and 1457 patients (64%) underwent resection with systemic chemotherapy. Chemotherapy was associated with improved overall survival in unadjusted (5-year overall survival, 55% versus 70%) and adjusted analysis (HR 0.54, 95% CI 0.47–0.63,
p
< 0.001).
Discussion
Patients with small bowel lymphoma have a low five-year overall survival after surgery. Chemotherapy is associated with improved survival, although one third of patients do not receive this therapy. Several other clinical factors are identified that are also associated with overall survival, including histology subtype, margin status, age, and medical comorbidities. This information can help with prognostication and potentially aid in treatment decision-making.</description><identifier>ISSN: 1091-255X</identifier><identifier>EISSN: 1873-4626</identifier><identifier>DOI: 10.1007/s11605-020-04730-3</identifier><identifier>PMID: 32666499</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Cancer therapies ; Chemotherapy ; Disease ; Duodenal Neoplasms ; Gastroenterology ; Histology ; Hospitals ; Humans ; Intestine, Small - surgery ; Lymphoma ; Lymphoma - surgery ; Medical diagnosis ; Medicine ; Medicine & Public Health ; Neoplasm Staging ; Original Article ; Patients ; Proportional Hazards Models ; Rare diseases ; Retrospective Studies ; Small intestine ; Statistical analysis ; Surgery ; Surgical outcomes ; Womens health</subject><ispartof>Journal of gastrointestinal surgery, 2021-03, Vol.25 (3), p.757-765</ispartof><rights>The Society for Surgery of the Alimentary Tract 2020</rights><rights>The Society for Surgery of the Alimentary Tract 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-ae022689bb51768697050853734f280bc51d051cb3258f815a6bb3d5ce5fd0a53</citedby><cites>FETCH-LOGICAL-c375t-ae022689bb51768697050853734f280bc51d051cb3258f815a6bb3d5ce5fd0a53</cites><orcidid>0000-0003-4960-3753</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11605-020-04730-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11605-020-04730-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32666499$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lu, Pamela W.</creatorcontrib><creatorcontrib>Fields, Adam C.</creatorcontrib><creatorcontrib>Yoo, James</creatorcontrib><creatorcontrib>Irani, Jennifer</creatorcontrib><creatorcontrib>Goldberg, Joel E.</creatorcontrib><creatorcontrib>Bleday, Ronald</creatorcontrib><creatorcontrib>Melnitchouk, Nelya</creatorcontrib><title>Surgical Management of Small Bowel Lymphoma</title><title>Journal of gastrointestinal surgery</title><addtitle>J Gastrointest Surg</addtitle><addtitle>J Gastrointest Surg</addtitle><description>Background
Primary small bowel non-Hodgkin’s lymphoma is a rare disease representing 2% of small intestine malignancies. There is limited data delineating the optimal treatment for these heterogeneous tumors. We aim to examine relationships between different treatment modalities and surgical outcomes in patients with small bowel lymphoma.
Materials and Methods
Patients diagnosed with stage I–III small bowel lymphoma in 2004–2015 who underwent surgery were identified in the National Cancer Database. Two cohorts were created based on systemic chemotherapy treatment status. The primary outcome was overall survival. An adjusted Cox proportional hazards model was used to evaluate the impact of treatment strategy on survival.
Results
2283 patients met inclusion criteria Of these patients, 826 patients (36%) underwent surgical resection alone, and 1457 patients (64%) underwent resection with systemic chemotherapy. Chemotherapy was associated with improved overall survival in unadjusted (5-year overall survival, 55% versus 70%) and adjusted analysis (HR 0.54, 95% CI 0.47–0.63,
p
< 0.001).
Discussion
Patients with small bowel lymphoma have a low five-year overall survival after surgery. Chemotherapy is associated with improved survival, although one third of patients do not receive this therapy. Several other clinical factors are identified that are also associated with overall survival, including histology subtype, margin status, age, and medical comorbidities. This information can help with prognostication and potentially aid in treatment decision-making.</description><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Disease</subject><subject>Duodenal Neoplasms</subject><subject>Gastroenterology</subject><subject>Histology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Intestine, Small - surgery</subject><subject>Lymphoma</subject><subject>Lymphoma - surgery</subject><subject>Medical diagnosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neoplasm Staging</subject><subject>Original Article</subject><subject>Patients</subject><subject>Proportional Hazards Models</subject><subject>Rare diseases</subject><subject>Retrospective Studies</subject><subject>Small intestine</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Womens health</subject><issn>1091-255X</issn><issn>1873-4626</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kE1LAzEQhoMotlb_gAdZ8CJIdJJsvo5a_IKKhyp4C9ndbG3Zj5p0kf57U7cqePA0A_PMO8OD0DGBCwIgLwMhAjgGChhSyQCzHTQkSjKcCip2Yw-aYMr56wAdhLAAIBKI2kcDRoUQqdZDdD7t_Gye2yp5tI2dudo1q6Qtk2ltqyq5bj9clUzW9fKtre0h2ittFdzRto7Qy-3N8_geT57uHsZXE5wzyVfYOqBUKJ1lnEihhJbAQXEmWVpSBVnOSQGc5BmjXJWKcCuyjBU8d7wswHI2Qmd97tK3750LK1PPQ-6qyjau7YKhKU1BS64goqd_0EXb-SZ-FymtpBaSbyjaU7lvQ_CuNEs_r61fGwJmo9L0Kk1Uab5UGhaXTrbRXVa74mfl210EWA-EOGpmzv_e_if2E-A1e0o</recordid><startdate>20210301</startdate><enddate>20210301</enddate><creator>Lu, Pamela W.</creator><creator>Fields, Adam C.</creator><creator>Yoo, James</creator><creator>Irani, Jennifer</creator><creator>Goldberg, Joel E.</creator><creator>Bleday, Ronald</creator><creator>Melnitchouk, Nelya</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4960-3753</orcidid></search><sort><creationdate>20210301</creationdate><title>Surgical Management of Small Bowel Lymphoma</title><author>Lu, Pamela W. ; Fields, Adam C. ; Yoo, James ; Irani, Jennifer ; Goldberg, Joel E. ; Bleday, Ronald ; Melnitchouk, Nelya</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-ae022689bb51768697050853734f280bc51d051cb3258f815a6bb3d5ce5fd0a53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Disease</topic><topic>Duodenal Neoplasms</topic><topic>Gastroenterology</topic><topic>Histology</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Intestine, Small - surgery</topic><topic>Lymphoma</topic><topic>Lymphoma - surgery</topic><topic>Medical diagnosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neoplasm Staging</topic><topic>Original Article</topic><topic>Patients</topic><topic>Proportional Hazards Models</topic><topic>Rare diseases</topic><topic>Retrospective Studies</topic><topic>Small intestine</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lu, Pamela W.</creatorcontrib><creatorcontrib>Fields, Adam C.</creatorcontrib><creatorcontrib>Yoo, James</creatorcontrib><creatorcontrib>Irani, Jennifer</creatorcontrib><creatorcontrib>Goldberg, Joel E.</creatorcontrib><creatorcontrib>Bleday, Ronald</creatorcontrib><creatorcontrib>Melnitchouk, Nelya</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastrointestinal surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lu, Pamela W.</au><au>Fields, Adam C.</au><au>Yoo, James</au><au>Irani, Jennifer</au><au>Goldberg, Joel E.</au><au>Bleday, Ronald</au><au>Melnitchouk, Nelya</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical Management of Small Bowel Lymphoma</atitle><jtitle>Journal of gastrointestinal surgery</jtitle><stitle>J Gastrointest Surg</stitle><addtitle>J Gastrointest Surg</addtitle><date>2021-03-01</date><risdate>2021</risdate><volume>25</volume><issue>3</issue><spage>757</spage><epage>765</epage><pages>757-765</pages><issn>1091-255X</issn><eissn>1873-4626</eissn><abstract>Background
Primary small bowel non-Hodgkin’s lymphoma is a rare disease representing 2% of small intestine malignancies. There is limited data delineating the optimal treatment for these heterogeneous tumors. We aim to examine relationships between different treatment modalities and surgical outcomes in patients with small bowel lymphoma.
Materials and Methods
Patients diagnosed with stage I–III small bowel lymphoma in 2004–2015 who underwent surgery were identified in the National Cancer Database. Two cohorts were created based on systemic chemotherapy treatment status. The primary outcome was overall survival. An adjusted Cox proportional hazards model was used to evaluate the impact of treatment strategy on survival.
Results
2283 patients met inclusion criteria Of these patients, 826 patients (36%) underwent surgical resection alone, and 1457 patients (64%) underwent resection with systemic chemotherapy. Chemotherapy was associated with improved overall survival in unadjusted (5-year overall survival, 55% versus 70%) and adjusted analysis (HR 0.54, 95% CI 0.47–0.63,
p
< 0.001).
Discussion
Patients with small bowel lymphoma have a low five-year overall survival after surgery. Chemotherapy is associated with improved survival, although one third of patients do not receive this therapy. Several other clinical factors are identified that are also associated with overall survival, including histology subtype, margin status, age, and medical comorbidities. This information can help with prognostication and potentially aid in treatment decision-making.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>32666499</pmid><doi>10.1007/s11605-020-04730-3</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-4960-3753</orcidid></addata></record> |
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| ispartof | Journal of gastrointestinal surgery, 2021-03, Vol.25 (3), p.757-765 |
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| language | eng |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Cancer therapies Chemotherapy Disease Duodenal Neoplasms Gastroenterology Histology Hospitals Humans Intestine, Small - surgery Lymphoma Lymphoma - surgery Medical diagnosis Medicine Medicine & Public Health Neoplasm Staging Original Article Patients Proportional Hazards Models Rare diseases Retrospective Studies Small intestine Statistical analysis Surgery Surgical outcomes Womens health |
| title | Surgical Management of Small Bowel Lymphoma |
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