Qiu WJ, Chen Y, Chen L, Zhao CF. Performance status as the central guide in managing primary gastrointestinal lymphoma. World J Gastrointest Oncol 2026; 18(10): 118805 [DOI: 10.4251/wjgo.118805]
Corresponding Author of This Article
Cheng-Fei Zhao, MD, PhD, Associate Professor, School of Pharmacy and Medical Technology, Putian University, No. 1133 Xueyuan Road, Chengxiang District, Putian 351100, Fujian Province, China. zhaochengfei209@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
editorial
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Qiu WJ, Chen Y, Chen L, Zhao CF. Performance status as the central guide in managing primary gastrointestinal lymphoma. World J Gastrointest Oncol 2026; 18(10): 118805 [DOI: 10.4251/wjgo.118805]
World J Gastrointest Oncol. Oct 15, 2026; 18(10): 118805 Published online Oct 15, 2026. doi: 10.4251/wjgo.118805
Performance status as the central guide in managing primary gastrointestinal lymphoma
Wen-Juan Qiu, Yan Chen, Li Chen, Cheng-Fei Zhao
Wen-Juan Qiu, Yan Chen, School of Basic Medicine Science, Putian University, Putian 351100, Fujian Province, China
Wen-Juan Qiu, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330006, Jiangxi Province, China
Li Chen, Cardiovascular Surgery Intensive Care Unit, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350000, Fujian Province, China
Cheng-Fei Zhao, School of Pharmacy and Medical Technology, Putian University, Putian 351100, Fujian Province, China
Cheng-Fei Zhao, Key Laboratory of Pharmaceutical Analysis and Laboratory Medicine in University of Fujian Province, Putian University, Putian 351100, Fujian Province, China
Co-first authors: Wen-Juan Qiu and Yan Chen.
Author contributions: Zhao CF and Qiu WJ mainly designed this paper; Zhao CF, Qiu WJ, Chen Y and Chen L checked and proofread this paper; Qiu WJ, Chen Y, Chen L and Zhao CF searched related literatures and information for this paper. All authors have read and approve the final manuscript. Qiu WJ and Chen Y contributed equally to this work as co-first authors.
Supported by Scientific Research Project of Putian University, No. 2022059; Special Project for Outstanding Young Talents of Putian University, No. 2024072; and Natural Science Foundation of Fujian Province, No. 2023J01160.
Conflict-of-interest statement: The authors declare that there is no conflict of interest in this paper.
Corresponding author: Cheng-Fei Zhao, MD, PhD, Associate Professor, School of Pharmacy and Medical Technology, Putian University, No. 1133 Xueyuan Road, Chengxiang District, Putian 351100, Fujian Province, China. zhaochengfei209@163.com
Received: January 12, 2026 Revised: February 15, 2026 Accepted: March 2, 2026 Published online: October 15, 2026 Processing time: 247 Days and 19.1 Hours
Abstract
Primary gastrointestinal lymphoma (PGIL) represents a unique and challenging frontier in oncologic care, sitting at the crossroads of hematology, gastroenterology, and surgery. Its rarity, anatomical diversity, and histological heterogeneity complicate the formulation of universal management guidelines and clear prognostic models. In this context, Buyuktalanci et al recently published a study in World Journal of Gastroenterology Oncology, the retrospective cohort study, provides a valuable, focused analysis of clinicopathological and prognostic factors in a Turkish cohort. Their work confirms the predominance of gastric location and diffuse large B-cell lymphoma histology while performing a rigorous statistical interrogation of survival determinants. The most salient finding-that a poor performance status (PS) (Eastern Cooperative Oncology Group score ≥ 2) stands as the sole independent prognostic factor for inferior overall survival in multivariate analysis-serves as the cornerstone for this editorial. This piece expands upon that finding, contextualizing it within the broader landscape of PGIL research. We explore the implications of this result for risk stratification, arguing for the renewed primacy of this simple clinical assessment in an era of complex molecular profiling. We dissect the study’s insights on the evolving role of surgery, the intriguing prognostic signal of Helicobacter pylori infection, and the notable absence of a survival difference between gastric and intestinal sites in this cohort. Finally, we propose an integrative model for future research, advocating for prospective, multinational registries that amalgamate traditional clinical parameters like PS with emerging molecular and genomic data. The ultimate goal is to refine a personalized, physiology-aware approach to PGIL that optimizes therapeutic intensity for those who can benefit while sparing others undue toxicity.
Core Tip: This study discusses primary gastrointestinal lymphoma (PGIL), a rare and heterogeneous cancer. It highlights a key finding from a recent study: Poor performance status (Eastern Cooperative Oncology Group score ≥ 2) is the strongest independent predictor of survival. We argue for the renewed integration of this fundamental clinical assessment with modern molecular profiling to guide personalized, risk-adapted therapy for PGIL, ensuring treatment intensity matches the patient’s physiologic capacity.
