{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T01:20:27Z","timestamp":1780363227018,"version":"3.54.1"},"reference-count":28,"publisher":"Wiley","issue":"21","license":[{"start":{"date-parts":[[2020,8,7]],"date-time":"2020-08-07T00:00:00Z","timestamp":1596758400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K12CA226330"],"award-info":[{"award-number":["K12CA226330"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["1R01CA233945"],"award-info":[{"award-number":["1R01CA233945"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Splenic marginal zone lymphoma (SMZL) is a rare tumor without a uniform treatment approach. The authors describe a large population\u2010based study evaluating survival outcomes of patients with SMZL according to the treatment received.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From the Surveillance, Epidemiology, and End Results database, patients were selected who had SMZL diagnosed from 1999 to 2016. Observation, splenectomy, chemotherapy, and splenectomy with chemotherapy were the evaluated treatment strategies. Cox and Fine and Gray regression models were used to evaluate overall and SMZL\u2010specific survival, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 1671 patients were selected for the analysis. Most patients were aged &gt;60 years (71.3%), White (89.7%), and non\u2010Hispanic (91.7%). Transformation to diffuse large B\u2010cell lymphoma (DLBCL) occurred in 71 patients (4.2%), and the 10\u2010year transformation rate was 8.6% (95% CI, 6.6%\u201010.9%). In multivariable analysis, shorter SMZL\u2010specific survival was associated with age \u226560 years (subdistribution hazard ratio [SHR], 1.85; 95% CI, 1.40\u20102.45; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), Hispanic ethnicity (SHR, 1.50; 95% CI, 1.06\u20102.13; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.023), DLBCL transformation (SHR, 2.10; 95% CI, 1.48\u20102.97; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), and the presence of B\u2010symptoms (SHR, 1.67; 95% CI, 1.23\u20102.27; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Compared with splenectomy, observation (SHR, 0.92; 95% CI, 0.67\u20101.28; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.636), chemotherapy only (SHR, 1.28; 95% CI, 0.93\u20101.76; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.127), and splenectomy plus chemotherapy (SHR, 1.43; 95% CI, 0.96\u20102.13; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.089) showed no significant differences in SMZL\u2010specific survival. Predictors of shorter overall survival were age \u226560 years (hazard ratio, 2.98; 95% CI, 2.37\u20103.76; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) and the presence of B\u2010symptoms (hazard ratio, 1.33; 95% CI, 1.06\u20101.67; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.014).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There were no significant differences in overall or SMZL\u2010specific survival by treatment strategy. Older age, Hispanic ethnicity, DLBCL transformation, and B\u2010symptoms were associated with a worse prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.33117","type":"journal-article","created":{"date-parts":[[2020,8,7]],"date-time":"2020-08-07T19:59:11Z","timestamp":1596830351000},"page":"4706-4716","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Splenic marginal zone lymphoma: A US population\u2010based survival analysis (1999\u20102016)"],"prefix":"10.1002","volume":"126","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0393-7889","authenticated-orcid":false,"given":"Jorge A.","family":"Florindez","sequence":"first","affiliation":[{"name":"Division of Hospital Medicine Miller School of Medicine University of Miami Miami Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2690-3377","authenticated-orcid":false,"given":"Juan Pablo","family":"Alderuccio","sequence":"additional","affiliation":[{"name":"Divison of Hematology Sylvester Comprehensive Cancer Center Miller School of Medicine University of Miami Miami Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isildinha M.","family":"Reis","sequence":"additional","affiliation":[{"name":"Division of Biostatistics Department of Public Health Sciences Miller School of Medicine University of Miami Miami Florida"},{"name":"Biostatistics and Bioinformatics Core Resource Sylvester Comprehensive Cancer Center Miller School of Medicine University of Miami Miami Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9346-9013","authenticated-orcid":false,"given":"Izidore S.","family":"Lossos","sequence":"additional","affiliation":[{"name":"Divison of Hematology Sylvester Comprehensive Cancer Center Miller School of Medicine University of Miami Miami Florida"},{"name":"Department of Molecular and Cellular Pharmacology University of Miami Miami Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,7]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"WHO Classification of Tumors of the Haematopoietic and Lymphoid Tissues","author":"Swerdlow SH","year":"2017"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2012.743655"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27773"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12011"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21931"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12036"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2012-0251"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-013-1900-4"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2016.03.005"},{"key":"e_1_2_8_11_1","volume-title":"SEER*Stat Database: Incidence\u2010SEER 18 Regs Research Data + Hurricane Katrina Impacted Louisiana Cases, November 2018 Submission (1975\u20102016 varying)\u2010Linked to County Attributes\u2010Total U.S., 1969\u20102017 Counties","author":"Surveillance, Epidemiology, and End Results (SEER) Program","year":"2019"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"key":"e_1_2_8_13_1","first-page":"1","article-title":"United States life tables, 2008","volume":"61","author":"Arias E","year":"2012","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-14-2154"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(03)00981-1"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2008.07301.x"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200110000-00007"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.00138"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1309\/MECJ-GLK1-WEBW-UEVE"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdn563"},{"key":"e_1_2_8_21_1","unstructured":"National Comprehensive Cancer Network (NCCN).NCCN Guidelines. 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