Primary Gastrointestinal Lymphoma: A Prospective Unicentric Study on a Romanian Cohort

Lymphomas of the gastrointestinal tract represent a rare pathology, frequently associated with a poor outcome. This study aimed to determine the prognostic factors of digestive tract lymphomas and to evaluate the role of endoscopy in the diagnosis and outcome.

Our prospective study evaluated a number of 63 patients diagnosed with digestive tract lymphomas.

The mean age of the patients was 62 years ± 13.1 years. Most of the patients had B-cell lymphoma (88.8%). Localization was represented by the stomach (44.4%), followed by the small bowel (25.4%) and the oropharynx (14.2%). Diffuse large B-cell lymphoma was the most common subtype (52.3%), followed by Mantle cell lymphoma (15.8%) and MALT (14.2%). T-cell lymphoma was present in a small number of patients. Anaplastic large cell lymphoma was the most common subtype of T-cell lymphoma (6.35%) and was localized in the small bowel. One-quarter of the patients had complications such as bleeding, obstruction, or perforation. Chemotherapy alone (38.1%) was the most common treatment option, followed by surgery (28.5%). Endoscopic examination and sampling biopsy were performed on 74.6% of the patients included in the study, with a positive diagnosis for lymphoma in 58.7% of the cases. Age (p=0.208), higher ECOG values (p=0.0487), and level of albumin (p=0.0355) were independent prognostic factors for overall survival. Endoscopic monitoring impacted overall survival (p<0.0001), due to the early detection of relapse.

Age, high ECOG value, and low albumin levels are independent prognostic factors for overall survival. Early diagnosis of recurrent gastrointestinal tract lymphomas by endoscopy increases overall survival.