title: [Primary small intestinal lymphoma: epidemiological, histological and therapeutic transition in Tunisia].
abstract: BACKGROUND
  Primary small intestinal lymphoma (PSIL) is the second Non-Hodgkin lymphoma (NHL) of the digestive tract (after gastric NHL).
  
  
  OBJECTIVE
  To evaluate during the past 28 years the epidemiological, anatomoclinical and therapeutic changes of PSIL in Tunisia through an acquired experience of more than a quarter of a century.
  
  
  METHODS
  Our retrospective study included patients with histologically confirmed small intestinal lymphoma from 1981 to 2008 in Tunisia at Salah Azaiz Institute. The cohort of 210 patients was divided into two groups: A group from 1981 to 1992 (152 patients) and B group from 1993 to 2008 (58 patients). We analysed the epidemiological, anatomoclinical, histological, and therapeutic characteristics.
  
  
  RESULTS
  We observed a significant decrease in the annual incidence of PSIL but also a significant transition of diffuse immunoproliferative small intestinal disease (IPSID) also known as "Mediterranean" PSIL, which were progressively replaced by "Western" lymphomas. Laparotomy with or without a debulking surgery, largely performed in group A, has disappeared at the cost of a primary chemotherapy (p < 0.001). Five-year actuarial global and relapse free survivals were respectively 60.5 and 57.3%.
  
  
  CONCLUSIONS
  PSIL in Tunisia were subjected to a triple transition: epidemiological, histological and therapeutic.
authors.affiliation: Institut Salah Azaiz, service d'oncologie médicale, Tunis, Tunisie. belaid_im@hotmail.fr
authors.forename: Imtinane
authors.initials: I
authors.lastname: Belaid
authors.forename: Amel
authors.initials: A
authors.lastname: Mezlini
authors.forename: Henda
authors.initials: H
authors.lastname: Rais
authors.forename: Mohamed Habib
authors.initials: MH
authors.lastname: Jaafoura
authors.forename: Hamouda
authors.initials: H
authors.lastname: Boussen
authors.forename: Hela
authors.initials: H
authors.lastname: Rifi
authors.forename: Mouna
authors.initials: M
authors.lastname: Ayadi
authors.forename: Nesrine
authors.initials: N
authors.lastname: Chraiet
authors.forename: Nouha
authors.initials: N
authors.lastname: Daoud
authors.forename: Houda
authors.initials: H
authors.lastname: El Benna
authors.forename: Farhat Ben
authors.initials: FB
authors.lastname: Ayed
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007161:Immunoproliferative Small Intestinal Disease / Q000453:epidemiology / Q000473:pathology; D015994:Incidence; D007414:Intestinal Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D007421:Intestine, Small / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D008297:Male; D012189:Retrospective Studies; D017678:Sex Distribution; D014416:Tunisia / Q000453:epidemiology