Primary Gastrointestinal Lymphoma: A Prospective Unicentric Study on a Romanian Cohort

Abstract

Background and Aims: Lymphomas of the gastrointestinal tract represent a rare pathology, frequently associated with a poor outcome. This study aimed to determine the prognostic factors of digestive tract lymphomas and to evaluate the role of endoscopy in the diagnosis and outcome.

Methods: Our prospective study evaluated a number of 63 patients diagnosed with digestive tract lymphomas.

Results: The mean age of the patients was 62 years ± 13.1 years. Most of the patients had B-cell lymphoma (88.8%). Localization was represented by the stomach (44.4%), followed by the small bowel (25.4%) and the oropharynx (14.2%). Diffuse large B-cell lymphoma was the most common subtype (52.3%), followed by Mantle cell lymphoma (15.8%) and MALT (14.2%). T-cell lymphoma was present in a small number of patients. Anaplastic large cell lymphoma was the most common subtype of T-cell lymphoma (6.35%) and was localized in the small bowel. One-quarter of the patients had complications such as bleeding, obstruction, or perforation. Chemotherapy alone (38.1%) was the most common treatment option, followed by surgery (28.5%). Endoscopic examination and sampling biopsy were performed on 74.6% of the patients included in the study, with a positive diagnosis for lymphoma in 58.7% of the cases. Age (p=0.208), higher ECOG values (p=0.0487), and level of albumin (p=0.0355) were independent prognostic factors for overall survival. Endoscopic monitoring impacted overall survival (p<0.0001), due to the early detection of relapse.

Conclusions: Age, high ECOG value, and low albumin levels are independent prognostic factors for overall survival. Early diagnosis of recurrent gastrointestinal tract lymphomas by endoscopy increases overall survival.