Division of Pediatric Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
J Pediatr Surg. 2011 Oct;46(10):1956-64. doi: 10.1016/j.jpedsurg.2011.06.006.
The objective of this study is to determine outcomes of pediatric patients with primary gastrointestinal tract lymphoma (PGTL) and the impact of surgery or radiation on survival.
The Surveillance, Epidemiology, and End Result database was queried from 1973 to 2006 for patients younger than 20 years with PGTL.
265 patients with PGTL were identified. Overall 5- and 10-year survivals were 84% and 83%, respectively. Tumors of the stomach (9%) and rectum/anus (2%) had the worst and best 10-year survivals, respectively (59% vs 100%, P = .023). There was no significant difference in 10-year survival for patients younger than 10 years of age who had surgical extirpation (83% vs 85% no surgery, P = .958) or radiotherapy (76% vs 85% no radiotherapy, P = .532). However, there was a significantly decreased 10-year survival in patients 10 years or older who had surgical extirpation (79% vs 100% no surgery, P = .013) or radiotherapy (49% vs 87% no radiotherapy, P = .001). Under multivariate analysis, tumor location was an independent predictor of improved survival (small bowel, HR 0.21, P = .002; large bowel, HR 0.23, P = .004).
We found no significant survival advantage for surgical extirpation or radiotherapy in patients younger than 10 years with PGTL, whereas either treatment modality was associated with lower survival in patients 10 years or older.
本研究旨在确定原发性胃肠道淋巴瘤（PGTL）儿科患者的结局以及手术或放疗对生存的影响。
从 1973 年至 2006 年，通过监测、流行病学和最终结果数据库对 20 岁以下患有 PGTL 的患者进行了检索。
确定了 265 例 PGTL 患者。总体而言，5 年和 10 年生存率分别为 84%和 83%。胃（9%）和直肠/肛门（2%）肿瘤的 10 年生存率最差和最好（分别为 59%和 100%，P=0.023）。10 岁以下接受手术切除（83%比无手术 85%，P=0.958）或放疗（76%比无放疗 85%，P=0.532）的患者 10 年生存率无显著差异。然而，10 岁以上接受手术切除（79%比无手术 100%，P=0.013）或放疗（49%比无放疗 87%，P=0.001）的患者 10 年生存率显著降低。多变量分析显示，肿瘤部位是生存改善的独立预测因素（小肠，HR 0.21，P=0.002；大肠，HR 0.23，P=0.004）。
我们发现，10 岁以下患有 PGTL 的患者手术切除或放疗均无明显生存优势，而这两种治疗方法在 10 岁以上患者中与较低的生存率相关。
