Surgery first had better prognosis and safety compared to chemotherapy first in patients with primary intestinal...

To investigate the efficacy and safety of patients with primary intestinal lymphoma (PIL) who received either surgery first or chemotherapy first, aiming to provide robust evidence for clinical treatment.

We collected the medical records of 82 patients with PIL from 2011 to 2020 for retrospective study. The patients was divided into two groups: the surgery first group (surgery followed by chemotherapy, SF group) and the chemotherapy first group (chemotherapy followed by surgery or without surgery, CF group).

The 3-year OS and 5-year OS of patients in SF group were higher than that in CF group (P < 0.05). Subgroup analysis showed that it had higher 5-year OS and 3-year OS in patients who were <60 years old, stage I-II, International Prognostic Index (IPI) score ≤2 or lymphoma located in the large bowel treated with SF compared to CF (P < 0.05). Univariate analysis revealed that patients <60 years old, with an IPI score of 1-2 and who underwent SF had a higher 5-year OS (P < 0.05). COX regression analysis demonstrated that age was an independent prognostic factor for OS (P = 0.006). The incidence of perioperative complications was lower in SF group than that in CF group (2.86 % vs. 36.17, P < 0.001). Univariate analysis and Multivariate logistic regression analysis both identified intestinal obstruction as the sole independent risk factor for surgery in CF group (P = 0.002).

The patients with PIL who received SF had better prognosis and greater perioperative safety than those who received CF.