Sex-specific differences in reproductive tract lymphomas: epidemiology, clinical features, and treatment outcomes.

BACKGROUND: The differences in the epidemiology, clinical characteristics, and treatment strategies between primary lymphoma of the female reproductive tract (PLFGT) and primary lymphoma of the male reproductive tract (PLMGT) remain unclear. MATERIALS AND METHODS: A retrospective analysis of PLFGT and PLMGT data from the surveillance, epidemiology, and end results database spanning 2000 to 2021 was conducted to compare the differences in incidence rates and clinical indicators. Bar chart analysis highlighted the distribution differences between lymphoma subgroups. Multivariate Cox regression models were used to identify prognostic factors. Kaplan-Meier analysis was performed to evaluate prognostic survival outcomes. RESULTS: Data from 724 patients with PLFGT and 2025 with PLMGT were analyzed, with diffuse large B-cell lymphoma (DLBCL) being the most prevalent subtype. The incidence of PLFGT was higher than that of PLMGT; however, the incidence rates in both groups decreased. Among DLBCL cases, the testis was the most frequent primary site in men, whereas the ovary predominated in women with follicular lymphoma. The prognostic risk factors for PLFGT included age, pathological type, primary site, surgery, and chemotherapy, whereas those for PLMGT include age, pathological type, chemotherapy, and radiation. In the DLBCL subtype of PLFGT in the study, combined chemotherapy and radiation reportedly enhance cancer-specific survival in patients in a limited stage (Ann Arbor stage I and II). In contrast, for patients with an advanced stage (Ann Arbor stage III and IV), combined chemotherapy and surgery yielded the most favorable survival outcomes. In the DLBCL subtype of PLMGT, combined chemotherapy, radiation, and surgery demonstrated the most effective therapeutic outcomes across both the limited and advanced stages. CONCLUSIONS: Clinical differences were observed between PLFGT and PLMGT. Prompt and accurate identification of risk factors and implementing integrated treatment strategies are essential for optimizing patient outcomes.