Jiang Jiao, Peng Jieyu, Huang Shu, Shi Xiaomin, Luo Bei, Xu Jia, Zhang Wei, Shi Lei, Lü Muhan, Tang Xiaowei
Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Street Taiping No.25, Region Jiangyang, Luzhou, 646099, Sichuan Province, China.
Department of Gastroenterology, Lianshui County People' Hospital, Huaian, China.
Clin Transl Oncol. 2025 Jun;27(6):2689-2699. doi: 10.1007/s12094-024-03768-y. Epub 2024 Nov 6.
Primary digestive system lymphoma (PDSL) is an important entity of extranodal lymphoma, yet updated epidemiologic and survival data are lacking.
Patients diagnosed with PDSL between 1975 and 2020 were identified from the Surveillance, Epidemiology, and End Results database. Kaplan-Meier analysis estimated survival outcomes. Multivariable Cox regression identified independent risk factors, and nomograms were developed to predict 1-, 3-, and 5-year overall survival (OS) and cancer-specific survival (CSS).
A total of 30,568 patients with PDSL were identified, with 57.9% being male and 80.4% white. The most frequent tumor site was the stomach (48.7%) and diffuse large B-cell lymphoma (DLBCL) was the predominant histologic subtype (45.0%). The overall incidence from 2016 to 2020 was 11.11 per 1,000,000 persons, with a decrease observed in lymphoma rates for the stomach, small intestine, large intestine, and pancreas. Long-term trends showed an initial rise in PDSL incidence, followed by a decline since the 1990s. The median OS across all patients was 103 months, with appendiceal lymphoma showing the highest median OS of 253 months. Factors including diagnosis year, age, sex, race, primary tumor site, histologic subtype, stage, and treatment modalities were significantly associated with OS and CSS. Nomograms achieved C-indices of 0.720 for OS and 0.723 for CSS in the training cohort.
The incidence of PDSL initially increased but has recently declined. Survival for all PDSL patients has improved over time. Nomograms to predict survival for patients with DLBCL exhibited good predictive and discriminating abilities.
原发性消化系统淋巴瘤（PDSL）是结外淋巴瘤的一个重要类型，但目前缺乏最新的流行病学和生存数据。
从监测、流行病学和最终结果数据库中识别出1975年至2020年间诊断为PDSL的患者。采用Kaplan-Meier分析估计生存结局。多变量Cox回归确定独立危险因素，并绘制列线图以预测1年、3年和5年总生存率（OS）和癌症特异性生存率（CSS）。
共识别出30568例PDSL患者，其中男性占57.9%，白人占80.4%。最常见的肿瘤部位是胃（48.7%），弥漫性大B细胞淋巴瘤（DLBCL）是主要的组织学亚型（45.0%）。2016年至2020年的总体发病率为每100万人11.11例，胃、小肠、大肠和胰腺的淋巴瘤发病率有所下降。长期趋势显示，PDSL发病率最初上升，自20世纪90年代以来呈下降趋势。所有患者的中位OS为103个月，阑尾淋巴瘤的中位OS最高，为253个月。诊断年份、年龄、性别、种族、原发肿瘤部位、组织学亚型、分期和治疗方式等因素与OS和CSS显著相关。在训练队列中，列线图的OS C指数为0.720，CSS C指数为0.723。
PDSL的发病率最初上升，但最近有所下降。随着时间的推移，所有PDSL患者的生存率都有所提高。用于预测DLBCL患者生存的列线图具有良好的预测和鉴别能力。
