Primary gastrointestinal tract lymphoma in the pediatric patient: review of 265 patients from the SEER registry.
OBJECTIVE
The objective of this study is to determine outcomes of pediatric patients with primary gastrointestinal tract lymphoma (PGTL) and the impact of surgery or radiation on survival.


METHODS
The Surveillance, Epidemiology, and End Result database was queried from 1973 to 2006 for patients younger than 20 years with PGTL.


RESULTS
265 patients with PGTL were identified. Overall 5- and 10-year survivals were 84% and 83%, respectively. Tumors of the stomach (9%) and rectum/anus (2%) had the worst and best 10-year survivals, respectively (59% vs 100%, P = .023). There was no significant difference in 10-year survival for patients younger than 10 years of age who had surgical extirpation (83% vs 85% no surgery, P = .958) or radiotherapy (76% vs 85% no radiotherapy, P = .532). However, there was a significantly decreased 10-year survival in patients 10 years or older who had surgical extirpation (79% vs 100% no surgery, P = .013) or radiotherapy (49% vs 87% no radiotherapy, P = .001). Under multivariate analysis, tumor location was an independent predictor of improved survival (small bowel, HR 0.21, P = .002; large bowel, HR 0.23, P = .004).


CONCLUSIONS
We found no significant survival advantage for surgical extirpation or radiotherapy in patients younger than 10 years with PGTL, whereas either treatment modality was associated with lower survival in patients 10 years or older.
Division of Pediatric Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
Noor
N
Kassira
Felipe E
FE
Pedroso
Michael C
MC
Cheung
Leonidas G
LG
Koniaris
Juan E
JE
Sola
D000293:Adolescent; D002051:Burkitt Lymphoma / Q000453:epidemiology / Q000532:radiotherapy / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000453:epidemiology* / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology* / Q000532:radiotherapy / Q000601:surgery; D008297:Male; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018426:SEER Program / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult