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The impact of surgery on long-term survival of patients with primary intestinal non-Hodgkin lymphomas based on SEER database.

ABSTRACT: Evidence regarding the need for surgery for primary intestinal non-Hodgkin lymphoma (PINHL) patients with chemotherapy is limited and controversial. We aimed to investigate the specific impact of surgery on survival of PINHL patients. Data from PINHL patients (aged > 18 years) with chemotherapy between 1983 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. We concerned about overall survival (OS) and improved cancer-specific survival (CSS). Propensity score matching (PSM) analysis was also used to explore the reliability of the results to further control for confounding factors. Finally, we screened 3537 patients. Multivariate regression analysis showed that patients with surgery and chemotherapy had better OS (hazard ratio [HR] 0.83; 95% confidence interval [CI] 0.75-0.93; p = 0.0009) and CSS (HR 0.87; 95% CI 0.77-0.99; p = 0.0404) compared with the non-operation group after adjusting for confounding factors. After PSM analysis, compared with non-surgery, surgery remained associated with improved OS (HR 0.77; 95% CI 0.68-0.87; p < 0.0001) and improved CSS (HR 0.82; 95% CI 0.72-0.95; p = 0.008) adjusted for baseline differences. In the large cohort of PINHL patients with chemotherapy older than 18 years, surgery was associated with significantly improved OS and CSS before and after PSM analysis.

SUBMITTER: Zhang C

PROVIDER: S-EPMC8630038 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThe aim of this retrospective study was to compare the long-term survival of patients receiving conservative with surgical treatment to analyze the prognostic factors and the impact of surgery on oncological outcomes of patients with primary gastric diffuse large B-cell lymphoma.MethodsA total of 2647 patients diagnosed with primary gastric diffuse large B-cell lymphoma from 1998 to 2014 were extracted from SEER database. Propensity matching was performed to compare the clinicopathological characteristics of the two groups. Based on the recursive partitioning analysis, the patients were divided into three risk subgroups: low risk, intermediate risk, and high risk.ResultsAfter propensity score matching, patient characteristics did not differ significantly between the two groups. The 5-year cancer-specific survival rates of the surgical group and the conservative treatment group were, respectively, 60% and 59.2% (P = 0.952) before propensity matching and 64.2% and 58.6% (P = 0.046) after propensity matching. According to the multivariate analysis, age, tumor stage, and chemotherapy and surgery were independent risk factors for long-term survival. The 5-year cancer-specific survival rates differed significantly between the low-risk, intermediate-risk, and high-risk patients (76.2% vs. 57.4% vs. 25.5%, respectively, P < 0.001). The 5-year cancer-specific survival rate of the surgical group was significantly higher than that of the conservative treatment group in the low-risk patients. However, it did not differ significantly in the intermediate-risk and high-risk patients (P > 0.05).ConclusionsA prognostic model was constructed based on the independent risk factors of age, tumor stage, and chemotherapy. The prognostic model indicated that low-risk patients (age < 75 years, stage I/II, with/without chemotherapy) undergoing surgical treatment may benefit from long-term survival, while intermediate- and high-risk patients (age ≥ 75 years, stage I/II, with/without chemotherapy or III/IV patients, with/without chemotherapy) gain no significant benefit from surgery.

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The impact of surgery on long-term survival of patients with primary intestinal non-Hodgkin lymphomas based on SEER database.

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