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Primary Gastrointestinal Lymphoma: A Retrospective Multicenter Clinical Study of 415 Cases in Chinese Province of Guangdong and a Systematic Review Containing 5075 Chinese Patients.
- Source :
-
Medicine [Medicine (Baltimore)] 2015 Nov; Vol. 94 (47), pp. e2119. - Publication Year :
- 2015
-
Abstract
- Primary gastrointestinal lymphoma (PGIL) is a rare malignant tumor without standard diagnosis and treatment methods. This study is aimed to systematically analyze its clinical characteristics and draw out an appropriate flow chart of diagnosis and treatment process for PGIL in China.This study retrospectively analyzed the clinicopathological characteristics, diagnostic approaches, prognostic factors, and therapeutic modalities in 415 cases of PGIL in Chinese province of Guangdong. A systematic review was conducted in 118 studies containing 5075 patients to further identify clinical manifestations and mortalities of therapeutic modalities.The most common clinical presentations were abdominal pain and bloody stools. Endoscopic biopsy was an important diagnostic means, and usually more than once to make a definite diagnosis. Retrospective multicenter clinical study showed that younger onset age (<60 years), female, one region involved, one lesion, early stage, International Prognostic Index (IPI ≤1), normal lactate dehydrogenase (LDH), normal albumin, and nonemergency operation were significant prognostic factors for B-cell lymphoma; non-B symptom, tumor restricted to gastric or ileocecal region, one lesion, performance status (PS ≤1), normal LDH, and nonsurgery alone were significant prognostic factors for T-cell lymphoma. Site of origin and IPI were independent prognostic factors for B-cell lymphoma; PS was the independent prognostic factor for T-cell lymphoma. And T-cell lymphoma had worse overall survival (OS) and progression-free survival (PFS) than B-cell lymphoma. Among different therapeutic modalities, chemotherapy alone or combined with surgery showed better OS and PFS than surgery alone for diffuse large B-cell lymphoma (DLBCL) of stage I/II E and T-cell lymphoma. For DLBCL of stage III E/IV and mucosa-associated lymphoid tissue lymphoma, OS and PFS did not differ among different therapeutic groups. In meta-analysis, surgery plus chemotherapy showed lowest mortality.Chemotherapy alone or combined with surgery may be the first-line treatment for DLBCL of stage I/II E and T-cell lymphoma. A flow chart of diagnosis and treatment process for PGIL was approximately drew out.<br />Competing Interests: The authors have no conflicts of interest to disclose.
- Subjects :
- Age Factors
China
Combined Modality Therapy
Endoscopy, Gastrointestinal
Female
Gastrointestinal Neoplasms therapy
Humans
Kaplan-Meier Estimate
Lymphoma therapy
Lymphoma, B-Cell mortality
Lymphoma, B-Cell pathology
Lymphoma, T-Cell mortality
Lymphoma, T-Cell pathology
Male
Middle Aged
Neoplasm Staging
Prognosis
Retrospective Studies
Sex Factors
Survival Analysis
Gastrointestinal Neoplasms mortality
Gastrointestinal Neoplasms pathology
Lymphoma mortality
Lymphoma pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1536-5964
- Volume :
- 94
- Issue :
- 47
- Database :
- MEDLINE
- Journal :
- Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 26632732
- Full Text :
- https://doi.org/10.1097/MD.0000000000002119