Routine interventions failed to provide survival benefits for early-stage major salivary gland marginal zone lymphoma in a population-based analysis.

Major salivary gland marginal zone lymphoma (MSGMZL) is a rare malignant tumor, predominantly presenting with early-stage (I/II) lesions. Given the scarcity of evidence for treatment efficacy, a comprehensive analysis of the long-term outcomes of various therapeutic approaches in early-stage MSGMZL is warranted. A population-based cohort study was conducted to include patients diagnosed with MSGMZL from 1992 to 2016, using data from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate Cox regression, propensity score matching (PSM), and stratified analyses were employed. A total of 1,091 early-stage MSGMZL cases were identified, with a median follow-up of 81.0 months. Key prognostic factors for overall survival included age over 60 years at diagnosis (hazard ratio [HR], 5.99; 95% confidence interval [CI], 4.36-8.24), diagnosis before 2005 (HR, 1.46; 95% CI, 1.10-1.95), and the presence of coexisting malignancy (HR, 1.61; 95% CI, 1.27-2.04). Disease-specific survival was adversely affected by age over 60 years at diagnosis (HR, 4.25; 95% CI, 2.34-7.75) and by the year of diagnosis before 2005 (HR, 1.98; 95% CI, 1.06-3.67). PSM revealed no differences in survival outcomes among conventional interventions. Subgroup analyses indicated that patients diagnosed after 2005 exhibited improved survival curves, suggesting the potential impact of novel therapeutic strategies. Our retrospective analysis indicates that conventional treatments do not confer a survival advantage for patients with early-stage MSGMZL. These findings underscore the urgent need for innovative therapeutic approaches and highlight the direction for future research aimed at improving patient outcomes.