title: Comparison of treatment strategies for patients with intestinal diffuse large B-cell lymphoma: surgical resection followed by chemotherapy versus chemotherapy alone.
abstract: The aim of this retrospective cohort study was to analyze the impact of surgery on the outcomes and qualities of life (QOL) in patients with intestinal diffuse large B-cell lymphoma (DLBCL). We assessed 345 patients with either localized or disseminated intestinal DLBCL and compared them according to treatment: surgical resection followed by chemotherapy versus chemotherapy alone. In patients with localized disease (Lugano stage I/II), surgery plus chemotherapy yielded a lower relapse rate (15.3%) than did chemotherapy alone (36.8%, P < .001). The 3-year overall survival rate was 91% in the surgery plus chemotherapy group and 62% in the chemotherapy-alone group (P < .001). The predominant pattern in the chemotherapy group was local relapse (27.6%). When rituximab was used with cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP), there was no improvement of the outcomes in patients treated with primary surgical resection. The QOL of patients who underwent surgery and chemotherapy was lower than chemotherapy alone, but its difference was acceptable. Multivariate analysis showed that surgical resection plus chemotherapy was an independent prognostic factor for overall survival. Surgical resection followed by chemotherapy might be an effective treatment strategy with acceptable QOL deterioration for localized intestinal DLBCL. This study was registered at www.clinicaltrials.gov as #NCT01043302.
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Kim
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Kang
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Kim
authors.forename: Sung Yong
authors.initials: SY
authors.lastname: Oh
authors.forename: Chul Won
authors.initials: CW
authors.lastname: Choi
authors.forename: Soon Il
authors.initials: SI
authors.lastname: Lee
authors.forename: Jong Ho
authors.initials: JH
authors.lastname: Won
authors.forename: Min Kyoung
authors.initials: MK
authors.lastname: Kim
authors.forename: Jung Hye
authors.initials: JH
authors.lastname: Kwon
authors.forename: Yeung-Chul
authors.initials: YC
authors.lastname: Mun
authors.forename: Jae-Yong
authors.initials: JY
authors.lastname: Kwak
authors.forename: Jung Mi
authors.initials: JM
authors.lastname: Kwon
authors.forename: In Gyu
authors.initials: IG
authors.lastname: Hwang
authors.forename: Hyo Jung
authors.initials: HJ
authors.lastname: Kim
authors.forename: Jinny
authors.initials: J
authors.lastname: Park
authors.forename: Sukjoong
authors.initials: S
authors.lastname: Oh
authors.forename: Jooryung
authors.initials: J
authors.lastname: Huh
authors.forename: Young Hyeh
authors.initials: YH
authors.lastname: Ko
authors.forename: Cheolwon
authors.initials: C
authors.lastname: Suh
authors.forename: Won Seog
authors.initials: WS
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D000069283:Rituximab; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone