Primary gastric non-Hodgkin's lymphoma: Clinical features, management, and prognosis of 185 patients with diffuse large B-cell lymphoma

Ibrahim, E. M.; Ezzat, A.; Raja, M. A.; Rahal, M.; Ajarim, Dahish; Mann, Bhupinder; Baloush, A; Stuart, Robert K.; Bazarbashi, Shouki

doi:10.1023/a:1008325823967

Cited by 25 publications

(8 citation statements)

References 27 publications

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“…Other sites of involvement have been associated with a worse prognosis, such as GI tract, respiratory system, liver, and pancreas. Several studies have reported an improved outcome in patients with gastric DLBCL , although this is likely associated with a better survival in patients with early stages. However, the prognosis in advanced stages has remained poor.…”

Section: Discussionmentioning

confidence: 99%

Sites of extranodal involvement are prognostic in patients with diffuse large B‐cell lymphoma in the rituximab era: An analysis of the Surveillance, Epidemiology and End Results database

2014

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Approximately a third of the patients with diffuse large B-cell lymphoma present with extranodal involvement. Our study aims to identify primary extranodal sites of disease associated with prognosis in patients with diffuse large B-cell lymphoma (DLBCL) in the rituximab era. A secondary objective is to describe epidemiological and clinical characteristics of patients with extranodal DLBCL. We included adult patients from the Surveillance, Epidemiology and End Results (SEER) database (2004)(2005)(2006)(2007)(2008)(2009) in whom DLBCL was the first malignancy diagnosed. Extranodal primary sites were divided into 12 groups according to the topography code reported by SEER. Multivariate overall survival (OS) analyses were performed using Cox proportional-hazard regression models adjusted for age, sex, race, and stage. From a total of 25,992 adult DLBCL patients included in our analysis, 32% presented with extranodal primary sites. Gastrointestinal tract (34%), head/neck (H&N; 14%), and skin/soft tissue (11%) were the most common. In comparison with nodal DLBCL, patients with extranodal involvement were older (with exception of skeletal sites) and presented with earlier stages. In the multivariate analysis, sites associated with worse OS rates were gastrointestinal (Hazard ratio (HR) 1.24, 95% confidence interval (CI) 1.15-1.33; P <0.001), pulmonary (HR 1.59, 95% CI 1.38-1.83; P <0.001), and liver/pancreas (HR 1.58, 95% CI 1.35-1.85; P <0.001), whereas H&N was associated with better survival (HR 0.79, 95% CI 0.70-0.89; P <0.001). In this population-based study, primary extranodal sites of involvement are associated with distinct outcomes in patients with DLBCL. Gastrointestinal, pulmonary, and liver/pancreas sites had a significant worse outcome than nodal sites.

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Section: Discussionmentioning

confidence: 99%

Sites of extranodal involvement are prognostic in patients with diffuse large B‐cell lymphoma in the rituximab era: An analysis of the Surveillance, Epidemiology and End Results database

2014

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“…In two recently published series of patients with primary gastric NHL, one from our institution and the other from the International Extranodal Lymphoma Study Group, the use of the IPI required modification. 28,29 Also in a large, randomized study of patients with stage I-II NHL, 87% of patients were considered low-risk according to the criteria of the IPI, and almost all patients (99%) were in the two lowest risk groups of that index. 30 Those published studies may imply that the IPI as originally proposed may lose its prognostic value if used without modification in certain groups of low-risk patients.…”

Section: Discussionmentioning

confidence: 99%

“…32 Of all tested variables in our study, only the modified IPI and the primary site (tonsil vs nontonsil) were found to prognosticate OS and EFS; however, the prognostic impact of the primary site was only minor. Modification to the original IPI was deemed necessary, and the prognostic values of those modified indices were shown in other extranodal sites 28,29 and for patients with nodal and extranodal localized NHL. 30 The site of localized extranodal lymphoma is an important independent determinant of outcome and is predictive of clinical behavior.…”

Section: Discussionmentioning

confidence: 99%

Localized non‐Hodgkin's lymphoma of Waldeyer's ring: Clinical features, management, and prognosis of 130 adult patients

et al. 2001

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This series characterized the clinicopathologic features and outcome of adult patients with early stage WR-NHLs. No survival difference was noted between stage I and stage II, and the outcome was favorable. Primary tonsillar site and the low-risk group of the modified IPI predicted favorable OS and EFS. CMT is probably superior to single modality treatment; however, prospective studies are warranted.

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“…In the present study, m-IPI retained their prognostic significance for shorter PFS and OS upon the Cox regression model. Previous studies (20,21) have indicated that m-IPI, in gDLBCL, is an effective prognostic factor, although it has not been reported that m-IPI at HT were adverse factors for PFS/OS. In a previous study, patients in the low-risk group (m-IPI ≤1) had significantly longer survival than intermediate/high-risk (m-IPI ≥2) patients.…”

Section: Discussionmentioning

confidence: 91%

Histological transformation from gastric mucosa-associated lymphoid tissue lymphoma to gastric diffuse large B-cell lymphoma

Meng

Sun

et al. 2017

Oncology Letters

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This study evaluated the clinical features, treatment and prognosis in Chinese patients with histological transformation (HT) from gastric mucosa-associated lymphoid tissue lymphoma to gastric diffuse large B-cell lymphoma. We reviewed the medical records of 71 patients diagnosed with HT between 2001 and 2013, retrospectively. Patients had a median age of 56 years. The ratio of sex (male:female) was 1.3:1. The clinical course was often insidious, lacking specific clinical presentation. Macroscopically, the antrum was the most commonly involved site. Thirty-one patients (45%) presented at stage I, and 25 (35%) presented with local (18/71, 25%) or distant (7/71, 10%) nodal involvement. There were also stage IIE (9/71, 12%) and stage IV (6/71, 8%) patients with advanced stages. For all 71 patients, the 5-year progression-free survival (PFS) and overall survival (OS) estimates were 50 and 56%, respectively. There was no statistical difference in 5-year PFS and OS estimates between patients receiving Helicobacter pylori (H. pylori) containing eradication (HPE) (p=0.189) and those receiving non-HPE (p=0.359). Upon the Cox regression model, advanced stages were the only independent prognostic factors associated with shorter PFS, and m-IPI was independently associated with shorter PFS and OS. There was no specific clinical manifestation for patients with HT. HPE is thus a promising therapeutic approach for such patients. Moreover, advanced stages and m-IPI significantly influenced patient outcome.

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Primary gastric non-Hodgkin's lymphoma: Clinical features, management, and prognosis of 185 patients with diffuse large B-cell lymphoma

Cited by 25 publications

References 27 publications

Sites of extranodal involvement are prognostic in patients with diffuse large B‐cell lymphoma in the rituximab era: An analysis of the Surveillance, Epidemiology and End Results database

Sites of extranodal involvement are prognostic in patients with diffuse large B‐cell lymphoma in the rituximab era: An analysis of the Surveillance, Epidemiology and End Results database

Localized non‐Hodgkin's lymphoma of Waldeyer's ring: Clinical features, management, and prognosis of 130 adult patients

Histological transformation from gastric mucosa-associated lymphoid tissue lymphoma to gastric diffuse large B-cell lymphoma

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