Primary gastrointestinal diffuse large B-cell lymphoma: A clinical analysis of 76 patients with special application of International Prognostic Index for survival / 대한내과학회지

ABSTRACT

BACKGROUND: Primary gastrointestinal lymphoma is one of the most common extranodal lymphomas. The purpose of this study was to collect information on the clinical features and treatment of patients with primary gastrointestinal diffuse large B-cell lymphoma (DLBCL) at a single healthcare facility in Korea. METHODS: Between May 1998 and December 2003, 76 primary gastrointestinal DLBCL patients at Asan Medical Center were identified and evaluated. RESULTS: Male patients accounted for 40 cases. The median age was 53 years. A total of 38 patients had primary gastric DLBCL. With a median follow-up of 25 months, the five year overall survival (OS) rate was 61.4% and the five year event free survival (EFS) rate was 59.3%. B symptoms, performance status, LDH levels and involved sites did not affect survival. Twenty-seven patients who underwent primary surgical resection did not demonstrate a difference in survival when compared to patients who did not undergo surgery. However, for intestinal lymphoma, primary surgical resection had a significant influence on EFS (p=0.030). Age (p=0.038), sex (p=0.017), stage (p=0.048), and the number of extranodal sites (p=0.002) were significant factors for EFS. The three year EFS rate for each International Prognostic Index (IPI) risk group was as follows 78.4% for low risk, 63.7% for low-intermediate risk, 30.0% for high-intermediate risk and 0% for high risk (p=0.002). Cox multivariate analysis revealed that the IPI was the only independent prognostic factor for EFS (p=0.002). CONCLUSIONS: Here we report on the unique pattern of clinical features of primary gastrointestinal DLBCL from a single healthcare center in Korea. The IPI system had prognostic value for primary gastrointestinal DLBCL.