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, Jinseok 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

Research output: Contribution to journalArticle

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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

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Chemotherapy
Lymphoma, Large B-Cell, Diffuse
Cells
Drug Therapy
Surgery
Therapeutics
Quality of Life
Recurrence
Vincristine
Prednisolone
Doxorubicin
Cyclophosphamide
Deterioration
Cohort Studies
Multivariate Analysis
Survival Rate
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

Kim, Seok Jin ; Kang, Hye Jin ; Kim, Jinseok ; Oh, Sung Yong ; Choi, Chul Won ; Lee, Soon Il ; Won, Jong Ho ; Kim, Min Kyoung ; Kwon, Jung Hye ; Mun, Yeung Chul ; Kwak, Jae Yong ; Kwon, Jung Mi ; Hwang, In Gyu ; Kim, Hyo Jung ; Park, Jinny ; Oh, Sukjoong ; Huh, Jooryung ; Ko, Young Hyeh ; Suh, Cheolwon ; Kim, Won Seog. / Comparison of treatment strategies for patients with intestinal diffuse large B-cell lymphoma : Surgical resection followed by chemotherapy versus chemotherapy alone. In: Blood. 2011 ; Vol. 117, No. 6. pp. 1958-1965.
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title = "Comparison of treatment strategies for patients with intestinal diffuse large B-cell lymphoma: Surgical resection followed by chemotherapy versus chemotherapy alone",
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.",
author = "Kim, {Seok Jin} and Kang, {Hye Jin} and Jinseok Kim and Oh, {Sung Yong} and Choi, {Chul Won} and Lee, {Soon Il} and Won, {Jong Ho} and Kim, {Min Kyoung} and Kwon, {Jung Hye} and Mun, {Yeung Chul} and Kwak, {Jae Yong} and Kwon, {Jung Mi} and Hwang, {In Gyu} and Kim, {Hyo Jung} and Jinny Park and Sukjoong Oh and Jooryung Huh and Ko, {Young Hyeh} and Cheolwon Suh and Kim, {Won Seog}",
year = "2011",
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doi = "10.1182/blood-2010-06-288480",
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Kim, SJ, Kang, HJ, Kim, J, Oh, SY, Choi, CW, Lee, SI, Won, JH, Kim, MK, Kwon, JH, Mun, YC, Kwak, JY, Kwon, JM, Hwang, IG, Kim, HJ, Park, J, Oh, S, Huh, J, Ko, YH, Suh, C & Kim, WS 2011, 'Comparison of treatment strategies for patients with intestinal diffuse large B-cell lymphoma: Surgical resection followed by chemotherapy versus chemotherapy alone', Blood, vol. 117, no. 6, pp. 1958-1965. https://doi.org/10.1182/blood-2010-06-288480

Comparison of treatment strategies for patients with intestinal diffuse large B-cell lymphoma : Surgical resection followed by chemotherapy versus chemotherapy alone. / Kim, Seok Jin; Kang, Hye Jin; Kim, Jinseok; Oh, Sung Yong; Choi, Chul Won; Lee, Soon Il; Won, Jong Ho; Kim, Min Kyoung; Kwon, Jung Hye; Mun, Yeung Chul; Kwak, Jae Yong; Kwon, Jung Mi; Hwang, In Gyu; Kim, Hyo Jung; Park, Jinny; Oh, Sukjoong; Huh, Jooryung; Ko, Young Hyeh; Suh, Cheolwon; Kim, Won Seog.

In: Blood, Vol. 117, No. 6, 10.02.2011, p. 1958-1965.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparison of treatment strategies for patients with intestinal diffuse large B-cell lymphoma

T2 - Surgical resection followed by chemotherapy versus chemotherapy alone

AU - Kim, Seok Jin

AU - Kang, Hye Jin

AU - Kim, Jinseok

AU - Oh, Sung Yong

AU - Choi, Chul Won

AU - Lee, Soon Il

AU - Won, Jong Ho

AU - Kim, Min Kyoung

AU - Kwon, Jung Hye

AU - Mun, Yeung Chul

AU - Kwak, Jae Yong

AU - Kwon, Jung Mi

AU - Hwang, In Gyu

AU - Kim, Hyo Jung

AU - Park, Jinny

AU - Oh, Sukjoong

AU - Huh, Jooryung

AU - Ko, Young Hyeh

AU - Suh, Cheolwon

AU - Kim, Won Seog

PY - 2011/2/10

Y1 - 2011/2/10

N2 - 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.

AB - 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.

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