title: Role of follow-up endoscopic examination in treatment response assessment for patients with gastric diffuse large B cell lymphoma.
abstract: OBJECTIVE
  According to lymphoma guidelines, gastric diffuse large B cell lymphoma (DLBCL) patients should undergo regular computed tomography (CT) and/or positron emission tomography (PET) examinations to assess treatment response. Endoscopic examinations are not indicated in the guidelines. The aim of this study was to investigate the utility of endoscopic examinations during and after treatment for DLBCL.
  
  
  METHODS
  We reviewed the patients diagnosed with gastric DLBCL at Seoul St. Mary's Hospital. All patients underwent endoscopy and radiologic examinations at every follow-up appointment. Radiologic response was defined according to World Health Organization criteria and endoscopic response was determined based on the Groupe d'Etude des Lymphomes de l'Adult grading system that is widely used in post-treatment evaluation of gastric MALT lymphoma.
  
  
  RESULTS
  Forty-five patients were analyzed. Within a median follow-up period of 34 months, 35 patients achieved both radiologic and endoscopic complete remission (CR). The median times to endoscopic and radiologic CR were not significantly different (21 versus 16 weeks, p = 0.118). However, in 25 patients with stage I disease, endoscopic CR [median (range), 20 (11-36)] was achieved later than radiologic CR [median (range), 13 (8-36)] (p = 0.027). Among 40 patients who achieved radiologic CR, 35 patients who also achieved endoscopic CR maintained remission during the follow-up. Two of the five patients who achieved radiologic CR without endoscopic CR experienced recurrence.
  
  
  CONCLUSIONS
  In gastric DLBCL patients, endoscopic response does not always correlate with radiologic response and might predict disease recurrence. We suggest that follow-up endoscopic examination with biopsy should be performed in addition to radiologic examination.
authors.affiliation: a Department of Gastroenterology, College of Medicine , The Catholic University of Korea , Seoul , South Korea ;
authors.forename: Seung Bae
authors.initials: SB
authors.lastname: Yoon
authors.affiliation: a Department of Gastroenterology, College of Medicine , The Catholic University of Korea , Seoul , South Korea ;
authors.forename: In Seok
authors.initials: IS
authors.lastname: Lee
authors.affiliation: a Department of Gastroenterology, College of Medicine , The Catholic University of Korea , Seoul , South Korea ;
authors.forename: Ha Ni
authors.initials: HN
authors.lastname: Lee
authors.affiliation: a Department of Gastroenterology, College of Medicine , The Catholic University of Korea , Seoul , South Korea ;
authors.forename: Eunyoung
authors.initials: E
authors.lastname: Kim
authors.affiliation: a Department of Gastroenterology, College of Medicine , The Catholic University of Korea , Seoul , South Korea ;
authors.forename: Woohyeon
authors.initials: W
authors.lastname: Kim
authors.affiliation: a Department of Gastroenterology, College of Medicine , The Catholic University of Korea , Seoul , South Korea ;
authors.forename: Han Hee
authors.initials: HH
authors.lastname: Lee
authors.affiliation: a Department of Gastroenterology, College of Medicine , The Catholic University of Korea , Seoul , South Korea ;
authors.forename: Bo-In
authors.initials: BI
authors.lastname: Lee
authors.affiliation: a Department of Gastroenterology, College of Medicine , The Catholic University of Korea , Seoul , South Korea ;
authors.forename: Myung-Gyu
authors.initials: MG
authors.lastname: Choi
authors.affiliation: b Department of Radiology, College of Medicine , The Catholic University of Korea , Seoul , South Korea ;
authors.forename: Seung Eun
authors.initials: SE
authors.lastname: Jung
authors.affiliation: c Department of Radiation Oncology, College of Medicine , The Catholic University of Korea , Seoul , South Korea ;
authors.forename: Byung Ock
authors.initials: BO
authors.lastname: Choi
authors.affiliation: d Department of Hospital Pathology, College of Medicine , The Catholic University of Korea , Seoul , South Korea ;
authors.forename: Gyeong Sin
authors.initials: GS
authors.lastname: Park
authors.affiliation: e Department of Hematology, College of Medicine , The Catholic University of Korea , Seoul , South Korea.
authors.forename: Seok-Goo
authors.initials: SG
authors.lastname: Cho
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D004724:Endoscopy / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000453:epidemiology; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011878:Radiotherapy / Q000379:methods; D012074:Remission Induction; D012189:Retrospective Studies; D066106:Seoul; D013274:Stomach Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Complete remission (CR); endoscopy; gastric diffuse large B cell lymphoma; recurrence