Clinical Features,Treatment And Prognosis Of Gastrointestinal Lymphoma:A Retrospective Study

Purpose:The purpose of this study is to characterize the clinical features of gastrointestinal lymphoma(GIL),to analyze the impact of treatment strategies on the patient outcomes,and to explore prognostic factors for GIL.Material and Methods:We reviewed 60 cases of GIL that were pathologically confirmed in the Second Affiliated Hospital,Zhejiang University School of Medicine from January 2011 to December 2015.For each patient,the data on clinical manifestation,laboratory results,pathology,clinical stage,therapeutic regimen and survival were collected.With SPSS 19.0 software,chi-square test was used for ratio comparison,survival was estimated from Kaplan-Meier curves and compared using the log-rank test,the COX proportional hazard model in the multivariate analysis to identify prognostic factors,P<0.05 was considered statistically significant.Results:In our cohort of 60 patients with GIL,the median age was 60 years(range 24 to 85 years),the male-to-female ratio was 1.61:1,and the gastric-to-intestinal involvment ratio was 2:3.The most common clinical manifestation was abdominal pain(71.7%),followed by abdominal distension(26.7%),loss of weight(23.3%),melena(16.7%);severe complications such as perforation,obstruction and hemorrhage occured mainly in intestinal lymphoma.As for pathological subtypes,diffuse large B cell lymphoma was the most common(66.7%),followed by mucosa-associated lymphoid lymphoma(15.0%),while T cell lymphoma was rare.According to the Lugano staging system,28 cases were assigned to early stage(?+?),and 32 were at advanced stage(IIE+IV).Fourteen(23.3%)patients with GILs underwent surgery only,21(35.0%)received chemotherapy alone,and 25(41.7%)received surgery plus chemotherapy.Univariate analysis showed that gastric involvement(P=0.02),normal level of lactic dehydrogenase(P=0.002),International Prognostic Index less than 3(P=0.006),B cell type(P=0.000)and chemotherapy(P=0.000)significantly prolong PFS and OS for all GIL patients.Multivariate analysis showed that pathological subtypes and levels of lactic dehydrogenase were the independent prognostic factors for GIL patients(P<0.01)?Conclusions:Gastric involvment,normal level of lactic dehydrogenase,International prognostic index less than 3,B cell subtype and chemotherapy prolong PFS and OS of GIL patients.Likewise,performance status had great predictive value for PFS and OS in advanced-stage GIL.T cell lymphoma and increased level of lactate dehydrogenase were the independent risk factors for OS.