Surgical resection plus chemotherapy versus chemotherapy alone: comparison of two strategies to treat diffuse large B-cell gastric lymphoma

Binn, Muriel; Ruskoné-Fourmestraux, A; Lepage, Éric; Haı̈oun, Corinne; Delmer, Alain; Aegerter, Philippe; Lavergne, A; Guettier, Catherine; Delchier, J.-C.

doi:10.1093/annonc/mdg495

Cited by 87 publications

(54 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this study, female predominance was documented, which was consistent with reports from Far East countries although literature from western countries reported male predominance (4,5,12,13,(19)(20)(21).…”

Section: Discussionsupporting

confidence: 90%

Retrospective analysis of primary gastric diffuse largeB-cell lymphoma: a single center study from Turkey

Soyer¹,

Özsan²,

Şahin³

et al. 2017

Turk J Med Sci

View full text Add to dashboard Cite

Background/aim: Diffuse large B-cell primary gastric lymphomas (DLBC-PGLs) are treated with different therapies. Their optimal treatment is not well documented. Materials and methods:We retrospectively analyzed the data of 51 patients diagnosed with DLBC-PGL in the previous 10 years. All patients were treated with R-CHOP as first line. Radiotherapy was added to chemotherapy in 8 patients. Surgery was performed in 5 patients.Results: The median follow-up time of the 51 patients was 45.5 (range 5-144) months and the complete response (CR) rate was 90.2%. CR was achieved in 34 (89.4%) of 38 patients treated with single chemotherapy, in all (100%) 5 patients treated with chemotherapy plus surgery, and in 7 (87.5%) of 8 patients treated with chemotherapy plus radiotherapy. The 5-year overall survival (OS) and event-free survival (EFS) rates were 85.8% and 89.6%, respectively. The 5-year OS and EFS rates were not significantly different between patients treated with single chemotherapy or chemotherapy plus radiotherapy/surgery (P > 0.05). Conclusion:R-CHOP chemotherapy is as effective as R-CHOP plus radiotherapy/surgery in the treatment of DLBC-PGL patients. Prospective randomized large cohort studies are needed to generate guidelines for the treatment of DLBC-PGL.

show abstract

Section: Discussionsupporting

confidence: 90%

Retrospective analysis of primary gastric diffuse largeB-cell lymphoma: a single center study from Turkey

Soyer¹,

Özsan²,

Şahin³

et al. 2017

Turk J Med Sci

View full text Add to dashboard Cite

show abstract

“…20,21 The benefit of radiotherapy might be its curative potential for attacking low-grade lymphoma components because the presence of low-grade lymphoma components can contribute to local relapse. 22 Unlike gastric DLBCL, the association of lowgrade lymphoma components with the risk of relapse is still controversial in primary intestinal DLBCL; the presence of lowgrade components is not consistent among previous studies of intestinal DLBCL.…”

Section: Discussionmentioning

confidence: 99%

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

Kim

Kang

Kim

et al. 2011

Blood

127

136

View full text Add to dashboard Cite

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. (Blood. 2011;117(6): [1958][1959][1960][1961][1962][1963][1964][1965]

show abstract

“…Primary gastric diffuse large B-cell lymphoma (PG-DLBCL) has been treated with various modalities, including surgery, chemotherapy and radiotherapy alone or in combination with other methods. Chemotherapy using cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) or CHOP-like regimens is considered to be the treatment of choice, due to its preferable outcomes (2)(3)(4)(5). On the contrary, surgery, which until a few decades ago was deemed an essential first-line therapeutic intervention, is now relegated to patients with massive bleeding or perforation at presentation.…”

Section: Introductionmentioning

confidence: 99%

Long-term follow-up of localized, primary gastric diffuse large B-cell lymphoma treated with rituximab and CHOP

Kobayashi

Hatta

Hojo

et al. 2011

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

Abstract. The addition of rituximab to cyclophosphamide, doxorubicin, vincristine and prednisone [CHOP (i.e., R-CHOP)] is considered to be the standard regimen for treating localized, primary gastric diffuse large B-cell lymphoma (PG-DLBCL). However, few studies have reported the long-term efficacy of R-CHOP therapy in the management of localized PG-DLBCL. In the present study, we performed a retrospective analysis of 11 patients with localized PG-DLBCL, who were treated with R-CHOP at Nihon University Itabashi Hospital and Kasukabe Municipal Hospital (Japan) from 2001 to 2008. Limited stage cancer was defined as stage I/II according to the Lugano staging system for gastrointestinal (GI) lymphomas. The relative dose intensity (RDI) of CHOP therapy was calculated for each patient. The median age of the patients was 68 years (range, 48-82). Gastralgia and anemia were common symptoms at initial presentation. All patients except 1 received 6 cycles of R-CHOP treatment without consolidative radiation therapy or prior surgery. RDI was maintained at over 80% in 9 out of 11 patients. All patients achieved complete remission and the estimated overall survival with a median follow-up of 54 months (range, 39-103) was 100%, without relapse or significant GI adverse effects, such as perforation or bleeding during R-CHOP treatment. No long-term adverse effects of rituximab were recorded during the observation period. Helicobacter pylori infection was diagnosed in 72.7% (8 cases) of the patients, but was eradicated in a limited number of patients. Our data suggest the feasibility and effectiveness of the addition of rituximab to conventional CHOP therapy in the management of localized PG-DLBCL.

show abstract

Surgical resection plus chemotherapy versus chemotherapy alone: comparison of two strategies to treat diffuse large B-cell gastric lymphoma

Abstract: This study shows that in localized gastric DLBCL with IPI 0-1, a similar 5-year survival rate (>90%) is to be expected with either surgery plus chemotherapy or chemotherapy alone.

Cited by 87 publications

References 34 publications

Retrospective analysis of primary gastric diffuse largeB-cell lymphoma: a single center study from Turkey

Retrospective analysis of primary gastric diffuse largeB-cell lymphoma: a single center study from Turkey

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

Long-term follow-up of localized, primary gastric diffuse large B-cell lymphoma treated with rituximab and CHOP

Contact Info

Product

Resources

About