Korean J Clin Oncol.  2017 Dec;13(2):75-82. 10.14216/kjco.17011.

Clinical outcomes of surgical management for primary gastrointestinal diffuse large B-cell lymphoma: At a single institution experience

• Jang SW
• Lim DR
• Kuk JK
• Kim T
• Shin EJ

• KMID: 2405645
• DOI: http://doi.org/10.14216/kjco.17011

Abstract

PURPOSE
The study aimed to analyze peri/postoperative outcomes and long-term oncologic outcomes after surgical management for primary gastrointestinal diffuse large B-cell lymphoma (DLBL).
METHODS
Between January 2001 and December 2013, 19 patients who underwent surgery for primary gastrointestinal DLBL were retrieved from a retrospective database.
RESULTS
With a median follow up of 49.2 months, the most common tumor locations were the terminal ileum and cecum (n=14, 73.7%) and stomach (n=4, 21.1%). The most common clinical symptoms were abdominal pain (n=15, 78.9%) and intussusceptions (n=5, 26.3%). None of the patients had B symptoms. Emergency surgery was undertaken in 36.8% (n=7) of the patients. Mean mass size was 8.4 cm; 4 patients (21.1%) had a bulky mass (>10 cm). The International Prognostic Index (IPI) scores were low (n=11, 57.9%), low-intermittent (n=7, 36.8%), and high-intermittent (n=1, 5.3%). Patients' staging was IE (n=9, 47.4%), IIE (n=8, 42.1%), and IVE (n=2, 10.5%) based on the Ann Arbor staging system, and I (n=2, 10.5%), II1 (n=5, 26.4%), IIE (n=10, 52.6%), and IV (n=2, 10.5%) based on the Lugano staging system. B-lymphocyte antigen CD20 was positive in most patients (n=17, 89.5%) and Ki-67 was high (>70%) in 12 patients (63.2%). Two types of chemotherapy were administered: cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisolone (n=5, 26.3%), rituximab, cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisolone (n=13, 68.4%). The 5-year disease-free survival rate was 94.4% and the 5-year overall survival rate was 89.5%.
CONCLUSION
Surgery for primary gastrointestinal DLBL is feasible and acceptable. Low staging of primary gastrointestinal DLBL has good prognosis.

Keyword

Lymphoma; Diffuse large B-cell lymphoma; Gastrointestinal tract; Surgery

MeSH Terms

Abdominal Pain
B-Lymphocytes*
Cecum
Cyclophosphamide
Disease-Free Survival
Drug Therapy
Emergencies
Follow-Up Studies
Gastrointestinal Tract
Humans
Ileum
Intussusception
Lymphoma
Lymphoma, B-Cell*
Prednisolone
Prognosis
Retrospective Studies
Rituximab
Stomach
Survival Rate
Vincristine
Cyclophosphamide
Prednisolone
Rituximab
Vincristine