Prognostic implications of tumor extent in early-stage diffuse large B-cell lymphoma.
Therapeutic strategies for early-stage diffuse large B-cell lymphoma (DLBCL) are often influenced by tumor extent, but the prognostic value of this parameter is rarely defined. Here, a retrospective analysis was performed to define the impact of tumor extent on survival of patients with early-stage DLBCL. Eighty-six patients with stage II DLBCL, diagnosed from 2000-2007, were categorized into localized (n = 55, 64 %) and disseminated groups (n = 31, 36 %) based on tumor extent at time of diagnosis. Treatment modalities, chemotherapy regimen and number of chemotherapy cycles were the same between groups. With a median follow-up of 7.6 years (range 2.1-12.1 years), overall 5-year event-free survival (EFS) and overall survival (OS) were 70.6 and 76.5 %, respectively. EFS (P = 1.00) and OS (P = 0.20) did not differ between the two groups. Older age (>60 years) was significantly associated with poor EFS (P = 0.01) and OS (P = 0.04). High-risk patients as rated by stage-modified international prognostic index (IPI) had inferior EFS (P = 0.04) and OS (P = 0.06) compared with the intermediate-risk group. These results indicate that tumor extent has no prognostic value in patients with early-stage DLBCL. Consistent with previous studies, age and stage-modified IPI were useful prognostic indices for these patients.
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea.
Changhoon
C
Yoo
Dok Hyun
DH
Yoon
Jeong Eun
JE
Kim
Jungmin
J
Jo
Seong Joon
SJ
Park
Shin-Kyo
SK
Yoon
Yongchel
Y
Ahn
Shin
S
Kim
Jooryung
J
Huh
Dae Ho
DH
Lee
Cheolwon
C
Suh
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult