Therapeutic Comparision of Surgical Resection Followed by R-CHOP and R-CHOP Alone for Primary Localized Intestinal Diffuse Large B Cell Lymphoma

Gastrointestinal tract is the most commonly involved extranodal site and is represented 10–15% of all non-Hodgkin¡&hibar;s lymphoma (NHL) cases and 30–40% of all extranodal sites. In this retrospective studies, the purpose is finding appropriate treatment strategy according to comparing the efficacy of treatment in patients with primary intestinal diffuse large B cell lymphoma (DLBL) undergoing surgery followed chemotherapy or chemotherapy alone.

Seventy six patients were newly diagnosed with DLBL and received chemotherapy between March 2004 and June 2011. Primary intestinal lymphoma which had predominant intestinal lesions was diagnosed by specialized hemato-oncologist. All patients were treated with rituximab combined cyclophosphamide, adriamycin, vincristine, and prednisolone (R-CHOP). Patients were divided into two groups. One included patients who were undertaken surgery followed by R-CHOP (surgery group). The other included patients who were undertaken R-CHOP alone (CT group).

The characteristics of the patients were as follows: the median age was 56.5 years (range 15–85 years) with a female-to-male ratio of 45: 31. Patients characteristics had no significant difference between two groups. The estimated 3 years progrression free survival rates (PFS) and overall survival rates (OS) of surgery and CT group were 92.2% and 74.8%, (p=0.009) and 94.2% and 80.7%, (p=0.049) respectively. In univariate analysis, PFS and OS were estimated in Lugano stage I, II1 and II2, IIE (p=0.006 and p=0.036), Low, Low-intermediate, and high-intermediate risk (p=0.004 and p=0.000), and surgery and CT alone, (p=0.009 and p=0.049), respectively. In multivariate analysis, there was no independent predictive factors for survival.

Patients treated with surgery followed by R-CHOP were seemed to have higher survival rate than R-CHOP alone although there was no significant differences for survival rate. There was no significant prognostic factors for survival but there were possible prognostic factors such as Lugano stage, IPI risk, and treatment modality for PFS and OS.

Figure. The superior survival rates were shown in surgery group than those in R-CHOP chemotherapy group.

No relevant conflicts of interest to declare.