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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 21, 2026; 32(7): 115406
Published online Feb 21, 2026. doi: 10.3748/wjg.v32.i7.115406
Published online Feb 21, 2026. doi: 10.3748/wjg.v32.i7.115406
Anatomical laterality of primary intestinal diffuse large B-cell lymphoma independently stratifies survival: New prognostic nomogram incorporating tumor location
Rui-Xin Zeng, Hang Yang, Peng Sun, Pan-Pan Liu, Zhao Wang, He Huang, Zhi-Ming Li, Xiao-Peng Tian, Yu Wang, Department of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
Cai-Qin Wang, Department of Lymphoma and Hematology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Cancer Hospital, Changsha 410013, Hunan Province, China
Lin-Chuan Wei, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
Ting-Ting Chen, Department of Hematology, Shenzhen Hospital of Southern Medical University, Shenzhen 518100, Guangdong Province, China
Co-first authors: Rui-Xin Zeng and Cai-Qin Wang.
Co-corresponding authors: Xiao-Peng Tian and Yu Wang.
Author contributions: Zeng RX and Wang CQ contributed equally to this work; Zeng RX performed the statistical analyses, prepared the figures and tables, and drafted the manuscript; Wang CQ obtained institutional review board approval for the study, coordinated data collection, and critically revised the manuscript for important intellectual content; Wei LC was responsible for case identification, data extraction; Yang H, Sun P, Liu PP, Chen TT, Wang Z, and Huang H contributed to data acquisition and curation, and assisted in data interpretation and manuscript revision; Li ZM, Tian XP, and Wang Y supervised the study, provided critical revision of the manuscript for important intellectual content, and approved the final version.
Supported by the National Natural Science Foundation of China, No. 82104273, No. 82422010, No. 82370190 and No. 82204414; Guangdong Basic and Applied Basic Research Foundation, No. 2024B1515020026; Hunan Provincial Natural Science Foundation of China, No. 2025JJ60485; and Innovative Tumor Supportive Care Research Project, No. cphcf-2023-157.
Institutional review board statement: The clinical data were acquired with the approval and permission of the Institutional Review Board of the Sun Yat-sen University Cancer Center. The study protocol was approved by the ethical committee of Sun Yat-sen University Cancer Center (approval No. B2024-241-01) and the study was performed under the principles of the Declaration of Helsinki.
Informed consent statement: Informed consent was not required because this study was a retrospective report of cases, which is a retrospective analysis of clinical data with no relevance to human biological ethic problems. The need for informed consent was waived by the ethical committee of the Sun Yat-sen University Cancer Center. All methods were performed following the relevant guidelines and regulations.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The SEER data and software used in this manuscript are publicly available at the following website: https://seer.cancer.gov/data-software/documentation/seerstat/.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu Wang, MD, Doctor, Department of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Yuexiu District, Guangzhou 510060, Guangdong Province, China. wangyu@sysucc.org.cn
Received: October 21, 2025
Revised: December 2, 2025
Accepted: December 26, 2025
Published online: February 21, 2026
Processing time: 109 Days and 5.9 Hours
Revised: December 2, 2025
Accepted: December 26, 2025
Published online: February 21, 2026
Processing time: 109 Days and 5.9 Hours
Core Tip
Core Tip: This study identifies intestinal laterality (left vs right of the splenic flexure) as a key, previously overlooked prognostic factor in primary intestinal diffuse large B-cell lymphoma (DLBCL): Left-sided disease confers worse overall survival, whereas right-sided disease even surpasses intra-abdominal nodal DLBCL. Leveraging SEER (n = 3832) and an external validation cohort (n = 107), we built and validated a simple nomogram (age, stage, chemotherapy, surgery, laterality) that delivered higher discrimination than the international prognostic index. The model operationalizes tumor location for individualized prognosis and may inform risk-adapted clinical decisions.