A study published in Cancer Medicine found that surgery may be a beneficial treatment option for certain patients with primary intestinal diffuse large B-cell lymphoma (PI-DLBCL).
The Surveillance, Epidemiology, and End Results program was queried to collect data on adult patients with PI-DLBCL. The researchers used Kaplan-Meier and Cox proportional regression analyses to determine the impact of surgical treatment. Lasso regression was implemented to identify factors associated with overall survival (OS) for a nomogram and a novel web‐based calculator. Concordance index, receiver operating characteristic curve, and calibration were used to evaluate the model’s performance.
Final analysis included 1,602 patients with PI-DLBCL. Surgery was associated with significantly improved survival upon univariate (P=0.007) and multivariate analyses (P<0.002). For patients who did not receive chemotherapy, local tumor destruction (LTD), compared to resection, was associated with better survival before propensity score matching was implemented. But upon matching, surgery remained associated with improved OS (P=0.0015), while LTD and resection no longer largely differed (P=0.32). Three-, five-, and 10-year predictions of OS per the nomogram were consistent between internal and external validation sets, according to the researchers.
“This study approves the beneficial effect of surgery on clinical endpoints in PI‐DLBCL patients. For those who are not suitable for resection, LTD may also be a practical option,” the authors wrote in their conclusion. “The predictive nomogram and the web‐based calculator could help clinicians individually evaluate the prognosis and optimize personalized treatment decisions for these patients.”