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Comparison of treatment strategies for patients with intestinal diffuse large B-cell lymphoma: surgical resection followed by chemotherapy versus chemotherapy alone.

Authors
 Seok Jin Kim  ;  Hye Jin Kang  ;  Jin Seok Kim  ;  Sung Yong Oh  ;  Chul Won Choi  ;  Soon Il Lee  ;  Jong Ho Won  ;  Min Kyoung Kim  ;  Jung Hye Kwon  ;  Yeung-Chul Mun  ;  Jae-Yong Kwak  ;  Jung Mi Kwon  ;  In GyuHwang  ;  Hyo Jung Kim  ;  Jinny Park  ;  Sukjoong Oh  ;  Jooryung Huh  ;  Young Hyeh Ko  ;  Cheolwon Suh  ;  Won Seog Kim 
Citation
 BLOOD, Vol.117(6) : 1958-1965, 2011 
Journal Title
BLOOD
ISSN
 0006-4971 
Issue Date
2011
MeSH
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antibodies, Monoclonal, Murine-Derived/administration & dosage ; Antineoplastic CombinedChemotherapyProtocols/administration & dosage ; Cohort Studies ; Combined Modality Therapy ; Cyclophosphamide/administration & dosage ; Disease-Free Survival ; Doxorubicin/administration & dosage ; Female ; Humans ; IntestinalNeoplasms/drug therapy* ; IntestinalNeoplasms/surgery* ; Kaplan-Meier Estimate ; Lymphoma,LargeB-Cell,Diffuse/drug therapy* ; Lymphoma,LargeB-Cell,Diffuse/surgery* ; Male ; Middle Aged ; Prednisone/administration & dosage ; Prognosis ; Quality of Life ; Retrospective Studies ; Rituximab ; TreatmentOutcome ; Vincristine/administration & dosage ; Young Adult
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
Files in This Item:
T201103406.pdf Download
DOI
10.1182/blood-2010-06-288480
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/94288
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