Performance status as the central guide in managing primary gastrointestinal lymphoma

Table 1 Summary of prognostic factors in the study by Buyuktalanci et al[17] and editorial commentary

Prognostic factor	Univariate analysis	Multivariate analysis	Editorial commentary and interpretation
ECOG PS ≥ 2	P < 0.0001, significant	P = 0.010, independent prognostic factor	Core perspective: PS is the cornerstone of prognostic assessment, reflecting the integration of host status and tumor burden. It should be prioritized in risk stratification
LDH ≥ 270 U/L	P = 0.029, significant	P = 0.085, not significant	A marker of tumor burden, but not independent of PS in this cohort. Possible collinearity with PS
Surgical treatment	P = 0.002, significant (associated with worse OS)	P = 0.384, not significant	Critical commentary: Although propensity score matching was used, unmeasured confounders (e.g., emergency indications, perioperative complications) may remain. Surgery likely serves as a marker-not a cause-of poor prognosis
IPI ≥ 3	OS: P = 0.095, not significant; EFS: P = 0.024, significant	Not entered into multivariate model	Inconsistent performance in PGIL; significance for EFS suggests predictive value for disease progression, but OS is dominated by host factors such as PS
Age ≥ 60 years	P = 0.529, not significant	-	Age did not show prognostic significance in this cohort, possibly due to the integrating effect of PS
Anatomical site (gastric vs intestinal)	OS: P = 0.531; EFS: P = 0.720, both not significant	-	Contrasts with some prior reports; may reflect the specific histological distribution or homogenization of treatment approaches in this cohort

ECOG: Eastern Cooperative Oncology Group; PS: Performance status; LDH: Lactate dehydrogenase; OS: Overall survival; EFS: Event-free survival; IPI: International Prognostic Index; PGIL: Primary gastrointestinal lymphoma.