Primary lymphoma of the female genital tract: An analysis of 697 cases

Objective. Primary lymphoma of the female genital tract (PLFGT) is a rare entity. The aim of this population based study was to elucidate the clinico-pathological, demographic characteristics and survival of women with PLFGT. Materials and methods. The Surveillance, Epidemiology, and End Results database was accessed and cases of PLFGT diagnosed between 1988 and 2012 were identified. Five-year overall (OS) and cancer-specific (CSS) survival rates were calculated with the Kaplan-Meier method. The influence of demographic and clinical parameters on survival was examined with the log-rank test. Factors independently associated with cancer-specific mortality were evaluated with a Cox proportional hazard model. Results. A total of 697 women with PLFGT were identified with a median age of 54 years. The most prevalent histological subtypes were diffuse large B-cell (59.8%) and follicular (11.9%) lymphoma. Tumors were most commonly located in the ovary (37%), cervix (21.4%), and uterus (16.5%). According to the Ann Arbor staging system, 42.6% and 17.9% of cases had stage I and stage II disease, respectively. Cancer -directed surgery (CDS) was performed in the majority of cases (62.8%). Five-year OS and CSS were 70.2% and 75.2% respectively. Localized disease, premenopausal age and follicular histology were associated with superior cancer-specific mortality while CDS did not confer any mortality benefit. Conclusions. This is the largest cohort of PLFGT presented in literature. While in our study surgical treatment was not associated with improved outcomes, larger multi-institutional studies should address the optimal management of women with PLFGT. (C) 2017 Elsevier Inc. All rights reserved.