Surgery shows survival benefit in patients with primary intestinal diffuse large B‐cell lymphoma: A population‐based study

BACKGROUND: The clinical characteristics and prognosis of primary intestinal diffuse large B‐cell lymphoma (PI‐DLBCL) are rarely reported. We aimed to explore the role of surgery in patients with PI‐DLBCL. METHODS: Adult PI‐DLBCL patients were included from the Surveillance, Epidemiology, and End Results database. The effect of surgery was evaluated by Kaplan–Meier and Cox proportional regression analyses. Propensity score matching (PSM) was used to reinforce our results. Lasso regression was utilized to determine independent risk factors of overall survival (OS) for a nomogram and a novel web‐based calculator. The performance of the model was measured via concordance index, receiver operating characteristic curve, and calibration plots in both cohorts. RESULTS: Overall, 1602 patients with PI‐DLBCL were analyzed. Surgery significantly improved survival in both univariate and multivariate analyses (p = 0.007, p < 0.001, respectively). Before PSM, local tumor destruction (LTD) displayed a survival advantage over resection in patients without chemotherapy (p = 0.034). After PSM, surgery was still identified as a beneficial factor for OS (p = 0.0015). However, there was no statistical difference between LTD and resection (p = 0.32). The nomogram for 3‐, 5‐, and 10‐year OS predictions exhibited dependable consistency between internal and external validation. CONCLUSION: This study approves the beneficial effect of surgery on clinical endpoints in PI‐DLBCL patients. For those who are not suitable for resection, LTD may also be a practical option. The predictive nomogram and the web‐based calculator could help clinicians individually evaluate the prognosis and optimize personalized treatment decisions for these patients.