Prognostic significance of age in adult primary intestinal diffuse large B-cell lymphoma: Insights from the SEER database

Surg Oncol. 2026 Jun 27;67:102493. doi: 10.1016/j.suronc.2026.102493. Online ahead of print.

ABSTRACT

BACKGROUND: Primary intestinal diffuse large B-cell lymphoma (PI-DLBCL) is a rare subtype of non-Hodgkin lymphoma. We aimed to evaluate the prognostic significance of age in patients with PI-DLBCL.

METHODS: The Surveillance, Epidemiology, and End Results (SEER) database 2000-2021 was reviewed for patients ≥18 years old diagnosed with PI-DLBCL. Overall survival (OS) and cancer-specific survival (CSS) were the primary endpoints. Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs). Patients were categorized as 18-59, 60-79, and ≥80 years old.

RESULTS: A total of 4167 patients were included. Compared to the 18-59 age group, patients aged 60-79 had worse OS (aHR = 2.39, 95% CI: 2.11-2.70) and CSS (aHR = 1.83, 95% CI: 1.57-2.13), and those ≥80 years old had the worst survival (OS/CSS: aHR = 5.25/3.86; 95% CI: 4.56-6.03/3.26-4.58). Across all age groups, chemotherapy (OS aHR range: 0.39-0.63) and surgery (OS aHR range: 0.65-0.78) were significantly associated with reduced mortality. In the 18-59 year old group, B symptoms (OS/CSS aHR = 1.52/1.81) and being unmarried or divorced/widowed (CSS aHRs: 1.49-1.59) predicted worse outcomes. In the 60-79 year old group, male sex (OS/CSS aHR = 1.25/1.25) and Black race (CSS: aHR = 1.71) were significant risk factors.

CONCLUSIONS: Age is a strong, independent predictor of survival in patients with PI-DLBCL. Younger patients had more diverse prognostic factors, while treatment status was the dominant determinant in older adults. These findings support age-specified treatment approaches for patients with PI-DLBCL.

PMID:42385448 | DOI:10.1016/j.suronc.2026.102493