Comparison of clinical features of patients with or without severe gastrointestinal complications in aggressive gastrointestinal lymphomas

Table 1 Clinicopathologic characteristics of 124 cases of aggressive primary gastrointestinal non-Hodgkin lymphoma, n (%)

Characteristics	No-GICs (n = 64)	GICs (n = 60)	P value
Age, mean ± SD	59.8 ± 12.5	60.0 ± 14.2	0.932
≥ 60	32 (50.0)	34 (56.7)	0.573
< 60	32 (50.0)	26 (43.3)
Gender			0.427
Male	35 (54.7)	38 (63.3)
Female	29 (45.3)	22 (36.7)
Stage			0.875
I/II	29 (45.3)	29 (48.3)
III/IV	35 (54.7)	31 (51.7)
LDH			0.406
Elevated	27 (42.2)	20 (33.3)
Normal	37 (57.8)	40 (66.7)
Virus			0.876
Yes	8 (12.5)	6 (10.0)
No	56 (87.5)	54 (90.0)
ECOG			0.139
0-1	59 (92.2)	49 (41.7)
≥ 2	5 (7.8)	11 (18.3)
Depth			< 0.001
Inside serous membrane	54 (87.5)	31 (51.7)
Serosal layer and outside	8 (12.5)	29 (48.3)
Diameter, mean ± SD	4.65 ± 2.4	7.03 ± 3.7	< 0.001
Primary site			< 0.001
Esophagus or stomach	40 (62.5)	15 (25.0)
Small intestine	12 (18.8)	26 (43.3)
Colon	12 (18.8)	19 (31.7)
Histopathology			< 0.001
DLBCL + BL	63 (98.4)	49 (81.7)
ITCL + NKTCL	1 (1.6)	11 (18.3)
N-GCB	39 (60.9)	43 (71.7)	0.284
CD5 +	13 (20.3)	7 (11.7)	0.287
CD30 +	5 (7.8)	7 (11.7)	0.673
Double expression	18 (28.1)	9 (15.0)	0.121
Ki 67 ≥ 70%	39 (60.9)	40 (66.7)	0.634
Macroscopic findings			0.858
Neoplasm	29 (45.3)	30 (50.0)
Ulceration	31 (48.4)	27 (45.0)
Others	4 (6.2)	3 (5.0)
Imaging findings			0.205
Neoplasticlesions	53 (82.8)	43 (71.7)
Others	11 (17.2)	17 (28.3)

PGINHL: Primary gastrointestinal non-Hodgkin lymphomas; GICs: Gastrointestinal complications; LDH: Lactate dehydrogenase, ECOG: Eastern cooperative oncology group; DLBCL: Diffuse large B-cell lymphoma; BL: Burkitt lymphoma; ITCL: Intestinal T-cell lymphoma; NKTCL: Natural killer/T-cell lymphoma; N-GCB: Non-germinal center B cells; CD: Cluster of differentiation; Ki: Kiel proliferation index.

Table 2 Univariate and multivariate analyses of factors associated with gastrointestinal complications in aggressive Primary gastrointestinal non-Hodgkin lymphomas patients

Characteristics	Univariate analysis		Multivariate analysis
	OR (95%CI)	P value	OR (95%CI)	P value
Age
≥ 60	1.21 (0.60-2.45)	0.597
< 60	Ref.	-
Gender
Male	1.48 (0.72-3.03)	0.289
Female	Ref.	-
Primary site
Esophagus or stomach	Ref.	-	Ref.
Small intestine	6.55 (2.61-16.40)	< 0.001	3.33 (1.47-9.41)	0.009
Colon	5.60 (2.15-14.61)	< 0.001	2.50 (1.17-7.15)	0.023
Histopathology
DLBCL + BL	0.08 (0.01-0.63)	0.017	0.09 (0.01-0.83)	0.033
ITCL + NK/T	Ref.	-	Ref.	-
Max tumor diameter	1.30 (1.13-1.48)	< 0.001	1.25 (1.07-1.47)	0.005
Invasive depth
Inside serous membrane	Ref.	-	Ref.
Serosal layer and outside	6.55 (2.67-16.06)	< 0.001	3.38 (1.24-9.19)	0.017
LDH
Elevated	0.67 (0.33-1.40)	0.287
Normal	Ref.	-
Virus
Yes	0.70 (0.23-2.14)	0.529
No	Ref.	-
Stage
I/II	Ref.	-
III/IV	0.82 (0.40-1.66)	0.581
ECOG
0-1	Ref.	-	Ref.	-
≥ 2	3.35 (1.02-11.05)	0.047	1.02 (0.24-4.39)	0.974
N-GCB	0.62 (0.29-1.31)	0.207
CD5 +	0.46 (0.17-1.25)	0.128
CD30 +	1.40 (0.42-4.68)	0.584
Double expression
Yes	0.40 (0.16-0.97)	0.044	0.51 (0.17-1.52)	0.227
No	Ref.	-	Ref.	-
Ki 67 ≥ 70%
Yes	1.13 (0.54-2.25)	0.747
No	Ref.	-
Macroscopic findings
Neoplasm	0.59 (0.12-2.88)	0.515
Ulceration	0.69 (0.33-1.42)	0.311
Others	Ref.	-
Imaging findings
Neoplasticlesions	0.49 (0.21-1.17)	0.109
Others	Ref.	-

LDH: Lactate dehydrogenase, ECOG: Eastern cooperative oncology group; DLBCL: Diffuse large B-cell lymphoma; BL: Burkitt lymphoma; ITCL: Intestinal T-cell lymphoma; NKTCL: Natural killer/T-cell lymphoma; N-GCB: Non-germinal center B cells; CD: Cluster of differentiation; Ki: Kiel proliferation index; CI: Confidence interval; NK: Nature killer.

Table 3 Treatments and outcomes of patients in the No-gastrointestinal complications vs gastrointestinal complications groups of aggressive primary gastrointestinal non-Hodgkin lymphomas

Characteristics	No-GICs (n = 64)	GICs (n = 60)	P value
Chemotherapy, n (%)			0.000
No	3 (4.7)	17 (28.3)
Yes	61 (95.3)	43 (71.7)
Radiotherapy, n (%)			0.022
No	49 (76.6)	55 (91.7)
Yes	15 (23.4)	5 (8.3)
Surgery, n (%)			0.000
No	61 (95.3)	5 (11.7)
Yes	3 (4.7)	53 (88.3)
Treatment, n (%)
Without CT	3 (4.7)	17 (28.3)	0.000
CT alone	43 (67.2)	4 (6.7)
CT + Sur/RT	18 (28.1)	39 (65.0)
EFS time, M (IQR)	21.0 (11.0, 36.0)	17.0 (5.5, 36.0)	0.580
OS time, M (IQR)	28.5 (14.5, 45.0)	24.5 (6.5, 47.5)	0.335
Death toll, n (%)	20 (31.3)	26 (43.3)	0.164

GICs: Gastrointestinal complications; CT: Chemotherapy; RT: Radiotherapy; Sur: Surgery; EFS: Event-free survival; OS: Overall survival; IQR: Interquartile range.

Table 4 Univariate and multivariate analyses of factors associated with overall survival in aggressive primary gastrointestinal non-Hodgkin lymphoma patients with gastrointestinal complications

Characteristics	Univariate analysis		Multivariate analysis
	HR (95%CI)	P value	HR (95%CI)	P value
Age
≥ 60	1.29 (0.58-2.84)	0.535
< 60	Ref.	-
Gender
Male	1.83 (0.77-4.36)	0.174
Female	Ref.	-
Primary site
Esophagus or stomach	Ref.	-
Small intestine	1.53 (0.55-4.31)	0.417
Colon	1.25 (0.41-3.82)	0.697
Histopathology
ITCL + NKTCL	5.58 (2.40-13.00)	< 0.001	8.75 (2.87-26.71)	< 0.001
DLBCL + BL	Ref.	-	Ref.	-
Max tumor diameter	1.03 (0.93-1.14)	0.598
Invasive depth
Inside serous membrane	Ref.	-
Serosal layer and outside	1.15 (0.53-2.49)	0.728
LDH
Elevated	3.33 (1.51-7.33)	0.003	3.90 (1.50-10.12)	0.005
Normal	Ref.	-	Ref.	-
Virus
Yes	2.13 (0.73-6.23)	0.169
No	Ref.	-
Stage
I/II	Ref.	-	Ref.	-
III/IV	6.29 (2.35-16.82)	< 0.001	5.49 (1.58-19.09)	0.007
ECOG
0-1	Ref.	-	Ref.	-
≥ 2	13.40 (5.39-33.35)	< 0.001	24.14 (6.28-92.70)	< 0.001
N-GCB	0.28 (0.09-0.94)	0.040
CD5 +	1.47 (0.51-4.28)	0.479
CD30 +	1.58 (0.57-4.92)	0.347
Double expression
Yes	1.55 (0.58-4.12)	0.380
No	Ref.	-
KI 67 ≥ 70%
Yes	0.95 (0.42-2.12)	0.891
No	Ref.	-
Treatment
Without CT	Ref.	-	Ref.	-
CT alone	0.85 (0.24-2.97)	0.800	1.82 (0.44-7.50)	0.407
CT + Sur/RT	0.07 (0.03-0.19)	< 0.001	0.07 (0.02-0.24)	< 0.001

LDH: Lactate dehydrogenase, ECOG: Eastern cooperative oncology group; DLBCL: Diffuse large B-cell lymphoma; BL: Burkitt lymphoma; ITCL: Intestinal T-cell lymphoma; NKTCL: Natural killer/T-cell lymphoma; N-GCB: Non-germinal center B cells; CD: Cluster of differentiation; Ki: Kiel proliferation index; CI: Confidence interval; NK: Nature killer; CT: Chemotherapy; RT: Radiotherapy; Sur: Surgery; HR: Hazard ratio.