Large bowel lymphoma: an analysis of prognostic factors and therapy in 53 patients.
OBJECTIVE
We performed a retrospective analysis to assess the influence of different prognostic factors, including the International Prognostic Index (IPI), that can predict the outcome in patients with primary large bowel lymphoma (Stage IE) treated with combined therapy (surgery followed by chemotherapy).


METHODS
All patients were treated with radical surgery followed by six cycles of combined chemotherapy: CHOP-Bleo (cyclophosphamide, doxorubicine, vincristine, prednisone, and bleomycin) or variants (epirubicin instead of doxorubicin). In all cases, an multivariate analysis was performed to identify prognostic factors (if any), including IPI, that can influence outcome.


RESULTS
According to the IPI, event-free survival (EFS) and overall survival were 85% and 87%, respectively, in patients with low and low-intermediate clinical risk that was not statistically significant when compared to patients at high and high-intermediate clinical risk: 69% and 76% (P = 2). Multivariate analysis failed to demonstrate the influence of multiple prognostic factors that were analyzed.


CONCLUSIONS
Combined therapy appears to be an excellent therapeutic approach in this group of patients with prolonged EFS and survival, and without late toxicity. However, no prognostic factors, including IPI, could be identified to define the best therapy, probably because the number of patients, even in large series, is limited. Multicentric studies are necessary to identify prognostic factors to define therapy and outcome in this rare clinical presentation of malignant lymphoma.
Avilés
Agustin
A
Department of Hematology, Oncology Hospital, National Medical Center, I.M.S.S., México D.F., Mexico. agaviles@avantel.net
Neri
Natividad
N
Huerta-Guzmán
Judith
J
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D002430:Cecal Neoplasms / Q000188:drug therapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000601:surgery; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000188:drug therapy* / Q000601:surgery; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000601:surgery; D012189:Retrospective Studies; D014750:Vincristine / Q000008:administration & dosage
D001761:Bleomycin; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone