title: Extranodal involvement in young patients with diffuse large B-cell lymphoma: distribution, prognostic value and treatment options.
abstract: OBJECTIVE
  Extranodal involvement represents a peculiar presentation of diffuse large B-cell lymphoma (DLBCL). Previous studies have suggested that older patients are more prone to extranodal involvement. This study retrospectively addressed the distribution, prognostic value and treatment options of extranodal involvement in young patients with DLBCL.
  
  
  METHODS
  A total of 329 patients were enrolled according to the inclusion requirements. The effects of gender, extranodal involvement, age-adjusted international prognostic index (aaIPI), rituximab infusion and radiotherapy on patient outcomes were evaluated.
  
  
  RESULTS
  Among these patients, 59% presented extranodal involvement in 16 anatomic sites. More than one instance was linked to many poorer clinical characteristics and poorer survival compared with either nodal disease or one instance. In patients with one extranodal lesion, multivariate analysis revealed that the site of extranodal involvement, but not the aaIPI or rituximab infusion, was independently related to the outcome, and radiotherapy had a negative influence on survival.
  
  
  CONCLUSIONS
  Extranodal involvement is common in younger patients and exhibits a ubiquitous distribution. The site of extranodal involvement is of strong prognostic significance. Radiotherapy for extranodal lesions does not improve patient outcomes.
authors.affiliation: Department of Internal Medicine, Henan Cancer Hospital & Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China.
authors.forename: Shuna
authors.initials: S
authors.lastname: Yao
authors.affiliation: Department of Internal Medicine, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, China.
authors.forename: Junbo
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Internal Medicine, Henan Cancer Hospital & Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China.
authors.forename: Zhihua
authors.initials: Z
authors.lastname: Yao
authors.affiliation: Department of Internal Medicine, Henan Cancer Hospital & Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China.
authors.forename: Yuanlin
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Internal Medicine, Henan Cancer Hospital & Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China.
authors.forename: Junfeng
authors.initials: J
authors.lastname: Chu
authors.affiliation: Department of Internal Medicine, Henan Cancer Hospital & Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China.
authors.forename: Jiuyang
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Internal Medicine, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, China.
authors.forename: Shuiling
authors.initials: S
authors.lastname: Jin
authors.affiliation: Department of Internal Medicine, Henan Cancer Hospital & Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China.
authors.forename: Yangyang
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Pathology, Henan Cancer Hospital & Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China.
authors.forename: Jianbo
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Pathology, Henan Cancer Hospital & Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Ma
authors.affiliation: Department of Internal Medicine, Henan Cancer Hospital & Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Internal Medicine, Henan Cancer Hospital & Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China.
authors.forename: Shujun
authors.initials: S
authors.lastname: Yang
authors.affiliation: Department of Internal Medicine, Henan Cancer Hospital & Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China.
authors.forename: Yanyan
authors.initials: Y
authors.lastname: Liu
keywords: Diffuse large B-cell lymphoma; extranodal involvement; prognosis