title: Comparison of therapeutic outcomes between surgical resection followed by R-CHOP and R-CHOP alone for localized primary intestinal diffuse large B-cell lymphoma.
abstract: OBJECTIVE
  There is no confirmed treatment strategy for primary intestinal diffuse large B-cell lymphoma (DLBL). In this retrospective study, the purpose is to find an appropriate treatment strategy in patients with primary intestinal DLBL undergoing surgery followed by chemotherapy or chemotherapy alone.
  
  
  METHODS
  Seventy-six patients were newly diagnosed with DLBL and received treatment between March 2004 and June 2011. Forty-seven patients were treated with surgical resection followed by rituximab combined with cyclophosphamide, adriamycin, vincristine, and prednisolone (R-CHOP), and 29 patients were treated with R-CHOP chemotherapy alone.
  
  
  RESULTS
  The characteristics of the patients were as follows: the median age was 56.5 years (range, 15 to 85 y) with a female to male ratio of 1.00:1.45. There was no significant difference in patient characteristics between the 2 groups. The estimated 3-year progression-free survival rates (PFS) and overall survival rates (OS) of surgery followed by R-CHOP (surgery/R-CHOP) and R-CHOP alone (R-CHOP) groups were 92.2% and 74.8% (P=0.009) and 94.2% and 80.7% (P=0.049), respectively. In univariate analysis, significant differences were seen in estimated PFS and OS rates when comparing Lugano stages I and II1 with II2 and IIE (P=0.006 and 0.036), low and low-intermediate risk with high-intermediate risk (P=0.004 and 0.000), and surgery/R-CHOP group with R-CHOP group (P=0.009 and 0.049), respectively. In multivariate analysis, there were no independent predictive factors for survival.
  
  
  CONCLUSIONS
  Patients treated with surgery followed by R-CHOP seemed to have a higher survival rate than those treated with R-CHOP alone. There were no significant prognostic factors for survival, but there were possible prognostic factors such as Lugano stage, International Prognostic Index risk, and treatment modality for PFS and OS.
authors.affiliation: Departments of *Internal Medicine †Occupational and Environmental Medicine, Kosin University College of Medicine ‡Department of Internal Medicine, Dong-A University Hospital §Department of Internal Medicine, Busan National University Hospital ∥Department of Internal Medicine, Busan Paik Hospital, Busan ¶Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu #Department of Hematology/Oncology, Ilsan Hospital, Goyang-si Gyeonggi-do **Department of Hematology, Catholic Blood and Marrow Transplantation Center, The Catholic University of Korea, College of Medicine ††Clinical Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Ho Sup
authors.initials: HS
authors.lastname: Lee
authors.forename: Lee Chun
authors.initials: LC
authors.lastname: Park
authors.forename: Eun Mi
authors.initials: EM
authors.lastname: Lee
authors.forename: Seong Hoon
authors.initials: SH
authors.lastname: Shin
authors.forename: Byeong Jin
authors.initials: BJ
authors.lastname: Ye
authors.forename: Sung Yong
authors.initials: SY
authors.lastname: Oh
authors.forename: Moo Kon
authors.initials: MK
authors.lastname: Song
authors.forename: Sang Min
authors.initials: SM
authors.lastname: Lee
authors.forename: Won Sik
authors.initials: WS
authors.lastname: Lee
authors.forename: Byung Woog
authors.initials: BW
authors.lastname: Kang
authors.forename: Myung Hee
authors.initials: MH
authors.lastname: Chang
authors.forename: Seok-Goo
authors.initials: SG
authors.lastname: Cho
authors.forename: Seung Ah
authors.initials: SA
authors.lastname: Yahng
authors.forename: Sung-Soo
authors.initials: SS
authors.lastname: Yoon
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Kwon
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D000069283:Rituximab; D015996:Survival Rate; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone