Extranodal MALT lymphoma: A retrospective survival analysis study from SEER database.

Abstract

e19043 Background: Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT), commonly referred to as extranodal MALT lymphoma, is an indolent B-cell neoplasm with diverse clinical presentations. This lymphoma frequently arises in various extranodal sites, including the stomach, thyroid gland, skin, lung, and occasionally as a disseminated disease. It is strongly associated with chronic infections such as Helicobacter pylori , Borrelia burgdorferi , and hepatitis C virus, as well as common genetic mutations involving MALT1 or BCL . Our study analyzes the epidemiologic trends of extranodal MALT lymphoma over the last two decades and evaluates factors contributing to favorable survival outcomes in SEER database. Methods: We extracted cases of extranodal MALT lymphoma using ICD 10 code 9699/3 from Surveillance, Epidemiology and End Result (SEER) database plus research data, Nov 2023 Sub (2000-2021). The analysis was divided based on age, gender, race, primary site labeled, treatment modality and median household income. Further, survival curves were compared using the Log-Rank Test ( Graph Pad Prism) . Results: A total of 33,073 cases of extranodal MALT lymphoma were identified in the SEER database between 2000-2021.Out of the 33,073 cases, 54% were females. Racial Distribution was observed as: Whites 70%, Hispanic 12%, Black 7%, Asian 7%, Unknown 1.3%, and the remaining were Alaskans. The median overall survival (MoS) for males was 141, and for females, it was 163 (p < 0.0001). Racial differences in survival showed the following MoS: 140 for Whites,169 for Blacks, 190 for Hispanics, 207 for Asians, and 194 for Alaskans (p < 0.0001). The survival varied by primary site: CNS 215, endocrine 216, GI tract 164, Breast 165 and Hematopoietic 103 (p<0.0001). Surgery was associated with better survival (MoS of 170) compared to no surgery (MoS of 144, p < 0.0001). Chemotherapy was linked to shorter survival (132 ) versus no chemotherapy (162, p < 0.0001). Radiation therapy improved survival (211) compared to no radiation (137, p < 0.0001). Socioeconomic status also influenced survival, with incomes above $100K associated with better outcomes (MoS of 173), compared to incomes below $70K (MoS of 141, p < 0.0001). Conclusions: Our study showed superior survival outcomes with female gender, Asian race, endocrinological sites. Our study highlights association between income and extranodal MALT lymphoma, showing higher survival outcomes as income increases. Treatment modalities also played a critical role; patients undergoing surgery or radiation therapy demonstrated superior survival compared to those without. Conversely, chemotherapy was associated with shorter MoS, likely secondary to the use of chemo in advanced disease.