Cancer Med. 2021 Oct;10(20):7060-7070. doi: 10.1002/cam4.4238. Epub 2021 Sep 21.
The effect of surgery on primary splenic lymphoma: A study based on SEER database.
Cancer medicine
Xiaotao Pan, Dongfeng Ren, Ya Li, Jin Zhao
Affiliations
Affiliations
- Department of General Surgery, Shaanxi Provincial Cancer Hospital, Xi'an, China.
- Department of Oncology, The First Hospital of Yulin, Yulin, China.
- Department of Oncology, Shaanxi Provincial Cancer Hospital, Xi'an, China.
- Department of Radiotherapy, Shaanxi Provincial Cancer Hospital, Xi'an, China.
PMID: 34547191
PMCID: PMC8525177 DOI: 10.1002/cam4.4238
Abstract
BACKGROUND: Although primary splenic lymphoma (PSL) is rare, it ranks first among splenic primary malignant cancers, and the incidence of lymphoma of spleen has gradually increased in recent years. However, the efficacy of surgery for PSL has not been clinically verified by large sample data, which has affected the formulation of relevant guidelines.
AIM: To assess whether surgery can enhance the prognosis PSL patients.
METHODS: Extracted the data of patients with PSL from The Surveillance, Epidemiology, and End Results (SEER) database, and divided the patients into surgery and non-surgery group. Kaplan-Meier curves and log-rank tests were used to compare the overall survival (OS) and cancer-specific survival (CSS). The propensity score matching (PSM) was used to match the data, then compared the OS and CSS again. The COX proportional hazard regression model was used for univariate and multivariate analysis. Finally, we performed subgroup analysis in different Ahmann stages.
RESULTS: A sum of 2207 patients with PSL were enrolled, of which 1062 (48.1%) patients received surgery, and 1145 (51.9%) patients did not undergo surgery. Overall, patients in the surgery group had better OS and CSS. After the propensity scores matching, surgery was not statistically significant in OS and CSS. In the subgroup analysis, surgery was a protective factor for the OS and CSS in Ahmann I/II. However, surgery was no statistical significance in OS and CSS in Ahmann III. In patients with Ahmann Ⅰ/Ⅱ SMZL, surgery was a protective factor for OS and CSS. In patients with Ahmann Ⅲ SMZL, surgery was also statistically significant of OS and CSS.
CONCLUSIONS: Surgery can significantly improve the prognosis of patients with Ahmann Ⅰ/Ⅱ primary splenic lymphoma, but there was no survival difference in the Ahmann Ⅲ patients with or without surgery. For patients with SMZL, surgery was effective for improving OS and CSS.
© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Keywords: SEER; primary splenic lymphoma; propensity score matching; surgery
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