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

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 Gyu Hwang, Hyo Jung Kim, Jinny Park, Sukjoong Oh, Jooryung Huh, Young Hyeh Ko, Cheolwon Suh, Won Seog Kim

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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.

Original languageEnglish
Pages (from-to)1958-1965
Number of pages8
JournalBlood
Volume117
Issue number6
DOIs
Publication statusPublished - 2011 Feb 10

All Science Journal Classification (ASJC) codes

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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    Kim, S. J., Kang, H. J., Kim, J. S., Oh, S. Y., Choi, C. W., Lee, S. I., Won, J. H., Kim, M. K., Kwon, J. H., Mun, Y. C., Kwak, J. Y., Kwon, J. M., Hwang, I. G., Kim, H. J., Park, J., Oh, S., Huh, J., Ko, Y. H., Suh, C., & Kim, W. S. (2011). Comparison of treatment strategies for patients with intestinal diffuse large B-cell lymphoma: Surgical resection followed by chemotherapy versus chemotherapy alone. Blood, 117(6), 1958-1965. https://doi.org/10.1182/blood-2010-06-288480