Management of complicated primary intestinal lymphoma in the emergency setting. Experience at quaternary hospital

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PURPOSE: Until now, there have been almost no published references that focus on the postoperative results of patients with complicated primary small bowel lymphoma (PSBL). Our goal is to analyze the postoperative results of patients who underwent emergency surgery for PSBL. METHODS: Retrospective observational study of patients diagnosed with complicated PSBL who underwent emergency surgery between 2016 and 2024. The presented gastrointestinal symptoms or findings in the imaging tests that showed hemorrhage, obstruction, or perforation. The incidence of postoperative complications, as well as total (TS) and disease-free survival (DFS) after surgery, were evaluated. RESULTS: Seventeen patients with the diagnosis of PSBL were analyzed. The most common clinical manifestation was intestinal obstruction (41.2%). The most frequent location was the ileum (47%). 40% of patients were diagnosed with diffuse large B-cell lymphoma (41.2%). In total, 12 patients (70.7%) had Lugano stage I disease. The mean TS of the patients was 39 months (range: 32–46). The TS of the patients with B-cell lymphoma was higher than T-cell lymphoma (B-cell lymphoma 27 months vs. T-cell lymphoma 8 months, P = 0.018). The median DFS was 41 months (range: 33–49). The DFS of patients with B-cell lymphoma was higher than T-cell lymphoma (27 months vs. 6 months. P = 0.019). CONCLUSIONS: Emergency surgery due to complications in patients with primary intestinal lymphoma does not have negative predictive value on their survival. The prognosis is worse in patients with T-cell primary intestinal lymphomas with a higher rate of postoperative complications and recurrence.

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