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

Title
Comparison of treatment strategies for patients with intestinal diffuse large B-cell lymphoma: surgical resection followed by chemotherapy versus chemotherapy alone
Author(s)
김민경김석진[김석진]강혜진[강혜진]김진석[김진석]오성용[오성용]최철원[최철원]이순일[이순일]원종호[원종호]권정혜[권정혜]서철원[서철원]김원석[김원석]
Keywords
NON-HODGKINS-LYMPHOMA; GIT NHL 01/92/; GASTROINTESTINAL-TRACT; GERMAN MULTICENTER; GASTRIC-LYMPHOMA; CLINICAL-FEATURES; MANAGEMENT; PROGNOSIS; CHOP
Issue Date
201102
Publisher
AMER SOC HEMATOLOGY
Citation
BLOOD, v.117, no.6, pp.1958 - 1965
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 chemo-therapy 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. (Blood. 2011; 117(6): 1958-1965)
URI
http://hdl.handle.net/YU.REPOSITORY/25647http://dx.doi.org/10.1182/blood-2010-06-288480
ISSN
0006-4971
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의과대학 > 내과학교실 > Articles
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