Primary gastrointestinal tract lymphoma in the pediatric patient: review of 265 patients from the SEER registry

J Pediatr Surg. 2011 Oct;46(10):1956-64. doi: 10.1016/j.jpedsurg.2011.06.006.

Abstract

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).

Conclusion: 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.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adolescent
  • Burkitt Lymphoma / epidemiology
  • Burkitt Lymphoma / radiotherapy
  • Burkitt Lymphoma / surgery
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Female
  • Gastrointestinal Neoplasms / epidemiology*
  • Gastrointestinal Neoplasms / radiotherapy
  • Gastrointestinal Neoplasms / surgery
  • Humans
  • Infant
  • Kaplan-Meier Estimate
  • Lymphoma, Non-Hodgkin / epidemiology*
  • Lymphoma, Non-Hodgkin / radiotherapy
  • Lymphoma, Non-Hodgkin / surgery
  • Male
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • SEER Program / statistics & numerical data
  • Treatment Outcome
  • United States / epidemiology
  • Young Adult