title: Management of Primary Gastrointestinal Non-Hodgkin Lymphomas: a Population-Based Survival Analysis.
abstract: Primary gastrointestinal non-Hodgkin lymphomas (PGINHL) are a heterogeneous group of rare GI malignancies with limited data to guide management. This study describes management of PGINHL in a population-based registry and aims to determine the association between receipt of surgery and long-term survival.
  
  
  
  All adults diagnosed with PGINHL over 27 years in the Surveillance, Epidemiology, and End Results were identified (excluding mucosa-associated lymphoid tissue lymphomas). Demographic and clinical characteristics were assessed. Survival was compared using the log-rank method. Cox hazard modeling was used to determine independent prognostic factors.
  
  
  
  We identified 16,129 patients. The majority were of gastric origin and had diffuse large B cell histology. Surgery was performed in 46.9 % of patients, not recommended in 41.8 % and recommended but not performed in 10.1 %. Overall 1-year and 5-year survival rates were 65.6 and 35.6 %, respectively. Patients undergoing surgery had a 5-year survival of 43.6 % compared to 34.8 % for whom surgery was recommended but not performed (p < .0001), (receipt of chemotherapy not available). Female gender, gastric location, follicular or mantle cell histology, and radiation therapy were associated with improved survival.
  
  
  
  Nearly 50 % of PGINHL patients underwent surgery. Surgery was not associated with improved survival. More prospective, case-matched studies are needed to guide management.
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA.
authors.forename: Evan Michael
authors.initials: EM
authors.lastname: Shannon
authors.affiliation: Department of Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, CA, 90095, USA. imacqueen@mednet.ucla.edu.|Department of Surgery, David Geffen School of Medicine at UCLA, 10833 LeConte Avenue, 72-215 Center for the Health Sciences, Box 956901, Los Angeles, CA, 90095-6901, USA. imacqueen@mednet.ucla.edu.
authors.forename: Ian T
authors.initials: IT
authors.lastname: MacQueen
authors.affiliation: Division of Hematology and Oncology, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, CA, 90095, USA.|Division of Hematology and Oncology, Olive View-UCLA Medical Center, 14445 Olive View Drive, Sylmar, CA, 91342, USA.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Miller
authors.affiliation: Department of Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, CA, 90095, USA.|Department of Surgery, Olive View-UCLA Medical Center, 14445 Olive View Drive, Sylmar, CA, 91342, USA.
authors.forename: Melinda
authors.initials: M
authors.lastname: Maggard-Gibbons
mesh_terms: D000368:Aged; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D018426:SEER Program; D012737:Sex Factors; D013270:Stomach / Q000473:pathology; D015996:Survival Rate
keywords: Gastrointestinal tract; Non-Hodgkin lymphoma; SEER Program; Surgery; Survival