No abstract

This retrospective study aimed to investigate clinical characteristics and prognostic factors in patients with primary gastrointestinal lymphoma (PGIL) of Chinese population.From January 2001 to December 2015, 137 patients diagnosed with PGIL were recruited. The clinical features, treatment, and follow-up information were analysed.The median patient age was 62.3 years. With 18.47 months follow-up, the 2-year progress-free survival and overall survival rate was 74.9% and 75.5%, respectively. The overall response rate was 33.6%. Age≥60 years, advanced Lugano staging (≥stage IIE), elevated lactate dehydrogenase (LDH) levels, ≥2 extra-nodal involved sites, National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI)≥4, Ki-67≥50% were associated with worse prognosis in univariate analysis (P < .05). By multivariate analyses, we determined that the involvement of extra-nodal involved sites was the only statistically significant poor prognostic factor in PGIL.Age, staging, LDH levels, NCCN-IPI, Ki-67 especially involvement of multiple extra-nodal sites were associated with poor overall survival of PGIL.

High response rate was concluded on very elderly B-cell lymphoma patients (≥80 years old) with reduced-dose R-CHOP. However, the very elderly patients with poor performance status and more complications benefit less from treatment.

Epithelioid sarcoma (ES) is a rare and highly invasive soft tissue malignant tumor with uncertain histogenesis. The localization of ES in the adrenal gland is rather unusual. The present study reported a case of stage IV ES in the adrenal gland of a 28-year-old male. The tissue biopsy of adrenal and lung lesions revealed epithelioid cells. Immunohistochemistry indicated that the tumor cells were strongly positive for cytokeratin (CK)8, CK, epithelial membrane antigen (EMA), CD34 and programmed cell death protein 1 ligand (PD-L1) but negative for nuclear integrase interactor 1 expression. The next-generation sequencing technology was applied using peripheral blood, indicating a low tumor mutation burden of 4.11 mutations (Muts)/Mb and somatic mutations in SMARCB1 . After diagnosis, the patient underwent unsuccessful palliative chemotherapy and radiotherapy. However, application of immune checkpoint inhibitors (ICIs) achieved partial remission and the overall survival reached 25 months. ICI monotherapy may be a feasible treatment for patients with ES with a strong expression of PD-L1.