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Research article
Lei Fan
Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9368-4987
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Pulmonary marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue type (MALT) is recognized as the most common type of primary pulmonary lymphomas. However, due to its relatively-low proportion, the studies focused on this patient population were limited. We aimed to reveal the status of surgery and radiotherapy in survival of pulmonary MALT lymphoma patients.
Methods
A retrospective analysis was conducted on patients who were pathologically diagnosed as pulmonary MALT lymphoma between 1992 and 2013. Their treatment information was collected in Surveillance, Epidemiology, and End Results (SEER) database. According to the different treatments, they were divided into four groups: Both Surgery and Radiation(SR), Surgery(S), Radiation(R) and No Surgery Or Radiation(NSR). The further subgroup analyses were performed according to age of onset and clinical stages. Overall survival (OS) was calculated from diagnosis up to the date of death or the last follow-up of each patient. Survival curves constructed by the Kaplan-Meier method and log-rank test were utilized for comparison.
Results
There were 860 pulmonary MALT lymphoma patients were enrolled. The median OS was 55.0 months (0-256.0 months). The OS between patients who underwent surgery and/or radiotherapy(S/R/SR) or not(NSR)(473 VS 387) had shown a significant difference of each other(P < 0.0001), so did the comparison among the four subgroups(SR VS S VS R VS NSR, P < 0.0001). Although there wasn’t any statistical difference in the OS between SR and S groups (P = 0.1174), further analysis on the causes of death revealed that, additional radiation therapy may lead to good short-term efficacy, while elevated mortality associated with long-term pulmonary complications was noteworthy. In the subgroup analyses, patients in stage I-II and over 60 years old shared similar trends with total population involved in the study(P = 0.0001;P < 0.0001).
Conclusions
The present study confirmed the value of surgery and the possible effects of radiotherapy among patients with pulmonary MALT lymphoma by clinical data from a large number of samples. If the improved radiotherapy regimens are chosen or the pulmonary complications caused by radiotherapy are well-managed, chances will be high that extra benefits could be achieved by combining radiotherapy with the surgical-based therapy.
Keywords
Pulmonary MALT lymphoma, Surgery, Radiation, SEER
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CURRENT STATUS: Under Review
Version 1
Posted 18 Aug, 2020
No community comments so far
Editorial decision: Reject after review
On 03 Jan, 2021
Reviewer #3 agreed
On 30 Dec, 2020
Review #3 received
Received 30 Dec, 2020
Reviewer #2 agreed
On 20 Dec, 2020
Review #2 received
Received 20 Dec, 2020
Review #1 received
Received 28 Sep, 2020
Reviewer #1 agreed
On 07 Sep, 2020
Reviewers invited
Invitations sent on 18 Aug, 2020
Editor assigned
On 05 Aug, 2020
First submitted
On 04 Aug, 2020
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On 04 Aug, 2020
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On 04 Aug, 2020
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This preprint is under consideration at BMC Cancer. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Lei Fan
Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9368-4987
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 18 Aug, 2020
No community comments so far
Editorial decision: Reject after review
On 03 Jan, 2021
Reviewer #3 agreed
On 30 Dec, 2020
Review #3 received
Received 30 Dec, 2020
Reviewer #2 agreed
On 20 Dec, 2020
Review #2 received
Received 20 Dec, 2020
Review #1 received
Received 28 Sep, 2020
Reviewer #1 agreed
On 07 Sep, 2020
Reviewers invited
Invitations sent on 18 Aug, 2020
Editor assigned
On 05 Aug, 2020
First submitted
On 04 Aug, 2020
Submission checks complete
On 04 Aug, 2020
Editor invited
On 04 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Pulmonary marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue type (MALT) is recognized as the most common type of primary pulmonary lymphomas. However, due to its relatively-low proportion, the studies focused on this patient population were limited. We aimed to reveal the status of surgery and radiotherapy in survival of pulmonary MALT lymphoma patients.
Methods
A retrospective analysis was conducted on patients who were pathologically diagnosed as pulmonary MALT lymphoma between 1992 and 2013. Their treatment information was collected in Surveillance, Epidemiology, and End Results (SEER) database. According to the different treatments, they were divided into four groups: Both Surgery and Radiation(SR), Surgery(S), Radiation(R) and No Surgery Or Radiation(NSR). The further subgroup analyses were performed according to age of onset and clinical stages. Overall survival (OS) was calculated from diagnosis up to the date of death or the last follow-up of each patient. Survival curves constructed by the Kaplan-Meier method and log-rank test were utilized for comparison.
Results
There were 860 pulmonary MALT lymphoma patients were enrolled. The median OS was 55.0 months (0-256.0 months). The OS between patients who underwent surgery and/or radiotherapy(S/R/SR) or not(NSR)(473 VS 387) had shown a significant difference of each other(P < 0.0001), so did the comparison among the four subgroups(SR VS S VS R VS NSR, P < 0.0001). Although there wasn’t any statistical difference in the OS between SR and S groups (P = 0.1174), further analysis on the causes of death revealed that, additional radiation therapy may lead to good short-term efficacy, while elevated mortality associated with long-term pulmonary complications was noteworthy. In the subgroup analyses, patients in stage I-II and over 60 years old shared similar trends with total population involved in the study(P = 0.0001;P < 0.0001).
Conclusions
The present study confirmed the value of surgery and the possible effects of radiotherapy among patients with pulmonary MALT lymphoma by clinical data from a large number of samples. If the improved radiotherapy regimens are chosen or the pulmonary complications caused by radiotherapy are well-managed, chances will be high that extra benefits could be achieved by combining radiotherapy with the surgical-based therapy.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
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