Primary colorectal lymphoma is rare, representing 0.2% to 0.6% of all colorectal cancers. Because of its low incidence and histologic variety, no treatment guidelines exist.
The purpose was to report the experience of primary colorectal lymphoma in an institutional and a national cohort.
This was a retrospective cohort study.
The study was conducted with institutional data composed of 3 tertiary referral centers and national data.
Patients with primary colorectal lymphoma were identified within the Mayo Clinic (1990–2016) and the Surveillance, Epidemiology, and End Results database (1990–2014).
Primary outcomes were overall and 5-year survival.
For the institutional cohort (N = 82), 5-year survival was 79.9%. Five-year survival was higher for rectal (88.4%) than for colon tumors (77.2%; p = 0.004). On multivariable analysis, age <50 years was associated with higher overall survival (p = 0.04). Left-sided colon masses and aggressive histological subtypes were associated with worse survival (0.04 and 0.03). No effect of treatment modality on survival was noted. For the national cohort (N = 2942), 5-year survival was 58.4%. Five-year survival for rectal tumors was 61.0% and 57.8% for colon tumors. On multivariable analysis, factors associated with improved survival were age <70 y, (p < 0.0001), female sex (p = 0.005), right-sided masses (p = 0.02), and diagnoses after 2000 compared with 1990–1999 (p < 0.0001). Aggressive pathology (p < 0.0001) and stage III or stage IV presentation compared with stage I (p = 0.02 and p < 0.0001) were associated with worse survival.
The institutional cohort was limited by sample size to describe treatment effect on survival. A major limitation of the national cohort was the ability to describe treatment modalities other than surgery, including chemotherapy and/or no additional treatment.
Poorer survival was noted in elderly patients and in those with aggressive pathology. An overall survival advantage was seen in women in the national cohort. Currently, optimal strategies should follow a patient-centered multidisciplinary approach. See Video Abstract at http://links.lww.com/DCR/A807.
1 Division of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, Phoenix, Arizona
2 Division of Health Care Research and Policy and Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
Funding/Support: None reported.
Financial Disclosure: None reported.
E-poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, Nashville, TN, May 19 to 23, 2018.
Correspondence: Nitin Mishra, M.D., Mayo Clinic, Division of Colon and Rectal Surgery, PX SP 03 GenSrg, 5777 E Mayo Blvd, Phoenix, AZ 85054. E-mail: Mishra.email@example.com