Role of Surgical Treatment in Primary Intestinal Non-Hodgkin Lymphomas: A SEER Population-Based Survival Analysis

Role of Surgical Treatment in Primary Intestinal Non-Hodgkin Lymphomas: A SEER Population-Based Survival Analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Role of Surgical Treatment in Primary Intestinal Non-Hodgkin Lymphomas: A SEER Population-Based Survival Analysis Cuifen Zhang, Xiaohong Zhang, Zeyu Liu, Jiahao Tao, Lizhu Lin, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-406885/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract Evidence regarding the need for surgery for primary intestinal non-Hodgkin lymphoma (PINHL) patients with chemotherapy is limited and controversial. We aimed to investigate the specific impact of surgery on survival of PINHL patients. Data from PINHL patients (aged >18 years) with chemotherapy between 1983 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. We concerned about overall survival (OS) and improved cancer-specific survival (CSS). Propensity score matching (PSM) analysis was also used to explore the reliability of the results to further control for confounding factors. Finally, we screened 3537 patients. Multivariate regression analysis showed that patients with surgery and chemotherapy had better OS (hazard ratio [HR], 0·83; 95% confidence interval [CI], 0·75–0·93; P=0·0009) and CSS (HR, 0·87; 95% CI, 0·77–0·99; P=0·0404) compared with the non-operation group after adjusting for confounding factors. After PSM analysis, compared with non-surgery, surgery remained associated with improved OS (HR, 0·77; 95% CI, 0·68–0·87; P<0·0001) and improved CSS (HR, 0·82; 95% CI, 0·72–0·95; P=0·008) adjusted for baseline differences. In the large cohort of PINHL patients with chemotherapy older than 18 years, surgery was associated with significantly improved OS and CSS before and after PSM analysis. Cancer Biology Oncology Medical Genetics PINHL SEER PSM CSS lymphomas Figures Figure 1 Figure 2 Figure 3 Full Text Due to technical limitations, full-text HTML conversion of this manuscript could not be completed. However, the manuscript can be downloaded and accessed as a PDF. Additional Declarations No competing interests reported. Supplementary Files SupplementaryFigure1.pdf Forest plots for (A) overall survival (OS) and (B) cancer specific survival (CSS) with surgery plus chemotherapy treatment after PSM (propensity score-matching). Adjusted HR was calculated based on the Cox proportional hazard model. Figure A of OS adjusting for age, year of diagnosis, Ann Arbor Stage, histologic and tumor site except the subgroup variable. Figure B of CSS adjusting for age, gender, marital status, year of diagnosis, Ann Arbor Stage, histologic, tumor site and radiation except the subgroup variable. SupplementaryTable1.pdf SupplementaryTable2.pdf Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Major revision 20 Jul, 2021 Reviews received at journal 20 Jun, 2021 Reviewers agreed at journal 14 Jun, 2021 Reviewers invited by journal 26 May, 2021 Editor assigned by journal 17 May, 2021 Editor invited by journal 07 May, 2021 Submission checks completed at journal 19 Apr, 2021 First submitted to journal 10 Apr, 2021 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-406885","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":22062372,"identity":"8997dc39-8744-4d7d-9c15-e6338b070998","order_by":0,"name":"Cuifen Zhang","email":"","orcid":"","institution":"the First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Cuifen","middleName":"","lastName":"Zhang","suffix":""},{"id":22062373,"identity":"9ae254b8-5498-4c62-a282-135724243311","order_by":1,"name":"Xiaohong Zhang","email":"","orcid":"","institution":"the First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Xiaohong","middleName":"","lastName":"Zhang","suffix":""},{"id":22062376,"identity":"4ed3f00a-e9f4-46c1-9d75-7ae8dbbd3124","order_by":2,"name":"Zeyu Liu","email":"","orcid":"","institution":"the First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Zeyu","middleName":"","lastName":"Liu","suffix":""},{"id":22062377,"identity":"71ee9f7c-7fa8-4eaa-8beb-4728cee1a969","order_by":3,"name":"Jiahao Tao","email":"","orcid":"","institution":"the First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jiahao","middleName":"","lastName":"Tao","suffix":""},{"id":22062379,"identity":"8499a4e1-8a77-4b35-bcdb-e817bcade47f","order_by":4,"name":"Lizhu Lin","email":"","orcid":"","institution":"Cancer Center, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Lizhu","middleName":"","lastName":"Lin","suffix":""},{"id":22062380,"identity":"6fa04132-bd59-4561-a160-a5f11c954789","order_by":5,"name":"Linzhu Zhai","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAyElEQVRIie3QMQrCMBSA4QeF6PDSbFJw6BVSujh4mAR3UQTHIghx8QAWQa9Qb1B5q+gBXAQvUOjS0TqIIELi5pCfN+aD9wLg8/1hYQDQDigIgrKsGgfC3oTpY752IfAigCl1mQvpcKqnJhuLFVYECLHolbbFQpXmhs0i4gVNBpDkW2UjKEfcoF48yQZByasDIW4ivSe8ETI3kiy5kbogBGeSBnhW+kBMtp8c2W8R4pTWOM/07kL3qmqGsehbyGfRb899Pp/P970H9jU7zjYRiHYAAAAASUVORK5CYII=","orcid":"","institution":"Cancer Center, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Linzhu","middleName":"","lastName":"Zhai","suffix":""}],"badges":[],"createdAt":"2021-04-10 07:29:06","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-406885/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-406885/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":8226348,"identity":"5ac37c5b-78e4-49a1-915c-c13916762035","added_by":"auto","created_at":"2021-04-20 14:39:04","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":73032,"visible":true,"origin":"","legend":"The Flowchart of inclusion and exclusion criteria.","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-406885/v1/fe7e11698ca6cccd3c780b2a.jpg"},{"id":8227075,"identity":"4d5a47dd-d82d-4a34-9860-518246ce697e","added_by":"auto","created_at":"2021-04-20 14:45:04","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":63513,"visible":true,"origin":"","legend":"Kaplan-Meier curves for (A) overall survival (OS) and (B) cancer specific survival (CSS), for (C) propensity score-matching (PSM) OS and (D) PSM CSS. 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Adjusted HR was calculated based on the Cox proportional hazard model. Figure A of OS adjusting for age, year of diagnosis, Ann Arbor Stage, histologic and tumor site except the subgroup variable. Figure B of CSS adjusting for age, gender, marital status, year of diagnosis, Ann Arbor Stage, histologic, tumor site and radiation except the subgroup variable.","description":"","filename":"SupplementaryFigure1.pdf","url":"https://assets-eu.researchsquare.com/files/rs-406885/v1/b5d90498d605e44f04adce2b.pdf"},{"id":8227076,"identity":"94f47224-f077-4b09-a74f-bfb45d0a9dbd","added_by":"auto","created_at":"2021-04-20 14:45:04","extension":"pdf","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":68620,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryTable1.pdf","url":"https://assets-eu.researchsquare.com/files/rs-406885/v1/3950c4078bc9702a38b2fdb6.pdf"},{"id":8226675,"identity":"c4b0aea6-70c2-4d33-a0d1-8ae4609aa47e","added_by":"auto","created_at":"2021-04-20 14:42:04","extension":"pdf","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":72362,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryTable2.pdf","url":"https://assets-eu.researchsquare.com/files/rs-406885/v1/ed60864e0b13da87aeba5c26.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eRole of Surgical Treatment in Primary Intestinal Non-Hodgkin Lymphomas: A SEER Population-Based Survival Analysis\u003c/p\u003e","fulltext":[{"header":"Full Text","content":"\u003cp\u003eDue to technical limitations, full-text HTML conversion of this manuscript could not be completed. 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We aimed to investigate the specific impact of surgery on survival of PINHL patients. Data from PINHL patients (aged \u003e18 years) with chemotherapy between 1983 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. We concerned about overall survival (OS) and improved cancer-specific survival (CSS). Propensity score matching (PSM) analysis was also used to explore the reliability of the results to further control for confounding factors. Finally, we screened 3537 patients. Multivariate regression analysis showed that patients with surgery and chemotherapy had better OS (hazard ratio [HR], 0·83; 95% confidence interval [CI], 0·75–0·93; P=0·0009) and CSS (HR, 0·87; 95% CI, 0·77–0·99; P=0·0404) compared with the non-operation group after adjusting for confounding factors. After PSM analysis, compared with non-surgery, surgery remained associated with improved OS (HR, 0·77; 95% CI, 0·68–0·87; P\u003c0·0001) and improved CSS (HR, 0·82; 95% CI, 0·72–0·95; P=0·008) adjusted for baseline differences. In the large cohort of PINHL patients with chemotherapy older than 18 years, surgery was associated with significantly improved OS and CSS before and after PSM analysis.","manuscriptTitle":"Role of Surgical Treatment in Primary Intestinal Non-Hodgkin Lymphomas: A SEER Population-Based Survival Analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2021-04-20 14:39:02","doi":"10.21203/rs.3.rs-406885/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2021-07-20T07:52:27+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2021-06-20T14:35:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"45f2854e-f15b-4eac-883f-446caa56dda4","date":"2021-06-14T05:17:20+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2021-05-26T17:48:37+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2021-05-17T19:43:38+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2021-05-07T12:32:44+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2021-04-19T09:39:48+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2021-04-10T07:23:40+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3bddd8b9-dbc4-49fc-a508-76df823d1025","owner":[],"postedDate":"April 20th, 2021","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":3770280,"name":"Cancer Biology"},{"id":3770281,"name":"Oncology"},{"id":3770282,"name":"Medical Genetics"}],"tags":[],"updatedAt":"2021-11-08T05:59:05+00:00","versionOfRecord":[],"versionCreatedAt":"2021-04-20 14:39:02","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-406885","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-406885","identity":"rs-406885","version":["v1"]},"buildId":"rHA-KDH7Qsr4HCuvH75dn","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}