Surgery plus chemotherapy versus chemotherapy alone in primary intestinal lymphoma: a meta-analysis

Objective Primary intestinal lymphomas (PILs) are uncommon tumors, but their incidence is increasing. Currently, their management is centered around systemic treatments, such as chemotherapy and radiotherapy, whereas surgery is restricted to selected indications. This meta-analysis aimed to evaluate the role of surgery in PIL treatment. Methods We collected publications comparing surgery plus chemotherapy versus chemotherapy alone in patients with PIL from 2000 to 2021. All trials analyzed the summary odds ratios (ORs) of endpoints, including the 5-year overall survival (OS), 3-year OS, and 3-year progression-free survival rates. Combined pooled ORs were analyzed using fixed- or random-effects models according to heterogeneity. Results Six studies were included. Compared with chemotherapy alone, surgery plus chemotherapy was associated with significantly higher 5-year OS [OR = 4.88, 95%confidence interval (CI) = 1.91–12.44, Z = 3.32], 3-year OS (OR = 3.83, 95%CI = 2.33–6.30, Z = 5.30), and 3-year progression-free survival (OR = 3.51, 95%CI = 2.20–5.58, Z = 5.29). Conclusions Surgery plus chemotherapy was associated with better outcomes than chemotherapy alone, especially in the early stages. Therefore, surgery plus chemotherapy may be the preferred strategy for appropriately selected patients with PIL. The protocol for this systematic review was registered at INPLASY (INPLASY202180102) and is available in full ( https: //doi.org/10.37766/inplasy2021.8.0102 ).

Association Between Celiac Disease and Cancer

Celiac disease (CD) is a chronic enteropathy that develops in genetically susceptible individuals after the ingestion of gluten. There has been a substantial increase in CD prevalence in the last 50 years, and it is now estimated that this disease affects approximately 1% of the population in the Western world. In the large majority of cases, CD is a benign disease, characterized by the complete resolution of symptoms and a normal life expectancy after the onset of a gluten-free diet (GFD). However, failure to adhere to a strict GFD bears the risk of adverse events and increases mortality. A considerable number of studies have considered the possible association between CD and neoplasms. In particular, an increased risk of malignancies, such as cancers of the gastrointestinal tract and intestinal lymphomas, has been reported. In this review, we summarize and discuss the current evidence on the possible association between CD and cancer.

Transcriptome Analysis and In Situ Hybridization for FcaGHV1 in Feline Lymphoma

Lymphoma is one of the most common malignancies in domestic cats. The lymphomagenicpotential of Felis catus gammaherpesvirus 1 (FcaGHV1), a common infection in domestic cats,is unknown. In other species, including humans, cellular transformation by gammaherpesvirusesis typically mediated by viral genes expressed during latency. We analysed tumour RNA, fromdiffuse large B-cell lymphomas (DLBCL) appearing in cats coinfected with FcaGHV1 and felineimmunodeficiency virus (FIV) (n = 10). Analysis was done by high throughput transcriptomesequencing and reverse transcription PCR. A limited repertoire of FcaGHV transcripts was identifiedin five tumors, including homologs of oncogenic latency-associated transcripts, latency-associatednuclear antigen (LANA, ORF73) and vFLIP (F7), lytic genes (ORF50, ORF6, ORF59, F10), and an ORFunique to FcaGHV1, F20. In situ hybridization of FIV-associated DLBCLs (n = 9), post-transplantlymphomas (n = 6) and high-grade B and T-cell intestinal lymphomas (n = 8) identified a single casein which FcaGHV1 nucleic acid was detectable. These results demonstrate that FcaGHV1 transcriptscan be detected in some FIV-associated lymphomas, but with a low copy number, precludingassessment of a potential role for FcaGHV1 in lymphomagenesis. Future investigation of the FcaGHV1transcriptome in clinical samples might employ viral enrichment and greater sequencing depth toenhance the retrieval of viral reads. Our results suggest prioritization of a subset of intestinal T-celltumors and large granular lymphocyte lymphoma, for study.

Clinical trends and management outcome of primary intestinal lymphoma

Background: Primary gastrointestinal lymphomas are the most common type of primary extra nodal lymphomas. In particular, primary intestinal lymphomas constitute about 25-40% of all gastrointestinal lymphomas. Our aim in this study is to find out the clinical patterns and surgical outcome in management of patients with primary intestinal lymphoma.Methods: A retrospective study at Sohag University Hospital from January 2013-to February 2017, included 17 cases, diagnosed histopathologically as primary intestinal lymphoma and subjected to surgical treatment. Demographic data, clinical presentations and management outcome were analyzed.Results: Seventeen consecutive patients with primary intestinal lymphoma, presented mainly by abdominal pain and abdominal mass. The definite preoperative diagnosis was detected only in 7 patients (41%) via preoperative histopathologic biopsy (3 by CT guided biopsy, 2 via diagnostic laparoscopy and remaining 2 by lower endoscopic biopsy). The other 10 patients (59%) were discovered incidentally during laparotomy. Radical resection was performed to 11 cases (65%), while palliative resection was employed to the remaining 6 cases. All patients received postoperative adjuvant chemotherapy. Two patients were lost to follow up, while the remaining investigated 15 cases, 3 of them were died (20%), 2 of the 3 total deaths presented with preoperative acute symptoms necessitating urgent laparotomy.Conclusions: Primary intestinal lymphomas are commonly diagnosed incidentally during abdominal exploration and most of them presented with abdominal pain. Complete surgical resection followed by adjuvant chemotherapy seems to be effective treatment in most cases. Surgical outcome of urgent cases of primary intestinal lymphoma carries poor prognosis.