Diffuse large B-cell lymphoma: clinical characterization and prognosis of Waldeyer ring versus lymph node presentation.
BACKGROUND
: The objective of this study was to compare the clinical features and prognosis of patients with diffuse large B-cell lymphoma (DLBCL) of Waldeyer ring (WR-DLBCL) and patients with lymph node DLBCL (N-DLBCL).


METHODS
: One hundred eighty-one patients with WR-DLBCL and N-DLBCL were reviewed. There were 57 patients with stage I disease, 83 patients with stage II disease, 26 patients with stage III disease, and 15 patients with stage IV disease. Among them, 101 patients had primary N-DLBCL, and 80 patients had primary WR-DLBCL.


RESULTS
: Patients with WR-DLBCL and N-DLBCL usually presented at an older age and had localized disease, a low frequency of B symptoms, a good performance status, and a low-risk International Prognostic Index (IPI) score. Compared with patients who had N-DLBCL, patients who had WR-DLBCL presented with more stage II disease and lower tumor burdens. The overall response rate after treatment was similar in both groups. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 76% and 61% in patients with WR-DLBCL, respectively, and 56% and 50% in patients with N-DLBCL, respectively (P = .119 for OS; P = .052 for PFS). IPI scores and elevated beta2-microglobulin and LDH levels were associated with a poor prognosis for patients who had WR-DLBCL; whereas bulky tumor, elevated beta2-microglobulin levels, and IPI scores were associated with poor OS for patients who had N-DLBCL.


CONCLUSIONS
: The current results supported the continued inclusion of WR-DLBCL as a lymph node group in the staging of DLBCL. Patients with WR-DLBCL had clinical features and prognosis similar to those of patients with N-DLBCL. Cancer 2009. (c) 2009 American Cancer Society.
Qi
Shu-Nan
SN
Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Li
Ye-Xiong
YX
Wang
Hua
H
Wang
Wei-Hu
WH
Jin
Jing
J
Song
Yong-Wen
YW
Wang
Shu-Lian
SL
Liu
Yue-Ping
YP
Zhou
Li-Qiang
LQ
Yu
Zi-Hao
ZH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008221:Lymphoid Tissue / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000145:classification / Q000175:diagnosis* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014067:Tonsillar Neoplasms / Q000175:diagnosis / Q000473:pathology; D016896:Treatment Outcome