Primary Gastrointestinal Non-Hodgkin’s Lymphoma of the Small and Large Intestines: a Systematic Review

Amy Lightner, Evan Shannon, Melinda Maggard Gibbons, Marcia M. Russell

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Primary gastrointestinal non-Hodgkin’s lymphoma (PGINHL) of small and large intestines is a group of heterogeneous, rare malignancies. Optimal treatment practices remain undefined. Methods: A systematic review (2003–2015) was performed to assess tumor characteristics, treatment practices, and treatment outcomes of PGINHL of small and large intestines. Results: Twenty-eight studies (1658 patients) were included; five focused on follicular lymphoma subtype. Of the non-follicular patients, 59.3 % presented with abdominal pain, 37.2 % were located in ileocecum, and 53.6 % were diffuse large B cell lymphoma subtype. The majority of patients (60.7 %) were treated with a combination of surgery and chemotherapy. Forty-three percent of studies concluded an overall survival benefit with surgery; none reported increased postoperative morbidity or mortality. Survival outcomes were not typically stratified by emergent versus elective surgery. Multivariate analysis within individual studies associated B cell lymphoma and ileocecum location with higher survival, while advanced stage and B symptoms were associated with poorer survival. Patients with asymptomatic follicular lymphoma had no progression with a watchful waiting approach. Conclusions: The majority of patients with non-follicular small and large intestinal PGINHLs are treated with both chemotherapy and surgery. Although surgery appears to be an important part of the treatment algorithm, definitive statements regarding its survival benefit remain limited due to lack of patient stratification based on timing and indication for surgery.

Original languageEnglish (US)
Pages (from-to)827-839
Number of pages13
JournalJournal of Gastrointestinal Surgery
Volume20
Issue number4
DOIs
StatePublished - Apr 1 2016
Externally publishedYes

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Large Intestine
Non-Hodgkin's Lymphoma
Small Intestine
Survival
Follicular Lymphoma
Watchful Waiting
Lymphoma, Large B-Cell, Diffuse
B-Cell Lymphoma
Combination Drug Therapy
Abdominal Pain
Neoplasms
Therapeutics
Multivariate Analysis
Morbidity
Drug Therapy
Mortality

Keywords

  • Large intestine
  • Lymphoma
  • Outcomes
  • Small intestine
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Primary Gastrointestinal Non-Hodgkin’s Lymphoma of the Small and Large Intestines : a Systematic Review. / Lightner, Amy; Shannon, Evan; Gibbons, Melinda Maggard; Russell, Marcia M.

In: Journal of Gastrointestinal Surgery, Vol. 20, No. 4, 01.04.2016, p. 827-839.

Research output: Contribution to journalArticle

Lightner, Amy ; Shannon, Evan ; Gibbons, Melinda Maggard ; Russell, Marcia M. / Primary Gastrointestinal Non-Hodgkin’s Lymphoma of the Small and Large Intestines : a Systematic Review. In: Journal of Gastrointestinal Surgery. 2016 ; Vol. 20, No. 4. pp. 827-839.
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