 ISSN 1392-0138 ISSN 2029-4174 (online) |
2008 m. Nr. 2 Impact of surgery and adjuvant chemotherapy versus chemotherapy alone on the survival of patients with primary gastric diffuse large B-cell lymphoma: a retrospective study
Introduction. The management of primary gastric diffuse large B-cell lymphoma (DLBCL) remains controversial. Historically, the treatment of localized gastric lymphoma was based on surgery alone or followed by chemotherapy and / or radiation therapy. The aim of this retrospective Materials and methods. Fifty-three patients (24 males, mean age 55.1 (range 19–82) years and 29 females, mean age 71 (range 30–82) years) with newly diagnosed primary gastric DLBCL were treated at four main hospitals of Lithuania in 1999–2005 and their treatment outcomes were reviewed. Twenty-one patients underwent primary gastrectomy (9 total and 12 partial gastrectomies), after which nineteen of them received adjuvant chemotherapy. Thirty-two patients received chemotherapy alone. Staging was performed according to Musshoff’s criteria. Survival was calculated from the date of diagnosis to patient’s death or to the last day known him to be alive. Survival curves were calculated using the Kaplan–Meier method, and the differences between the survival ranges were evaluated by the log-rank test. Results. Three years’ overall survival in patients with localised lymphoma treated by surgery plus adjuvant chemotherapy was 85.2% (52.6%–96.1%) versus 78.6% (47.3%–92.5%) in patients treated by chemotherapy alone (p = 0.2904). There was no significant difference in the overall one year’s survival in patients with disseminated lymphoma treated by surgery and adjuvant chemotherapy (14.3% [95%CI 0.7%–46.5%]) compared to those treated by chemotherapy alone (54.4% [95%CI 24.5%–76.8%]) (p = 0.0664). Conclusion. The results of this study suggest that surgery does not improve the survival of patients with either localized or disseminated primary gastric DLBCL compared to those receiving chemotherapy alone. Patients with advanced disease who undergo surgery may have an inferior outcome. Keywords: DLBCL, surgery and adjuvant chemotherapy, chemotherapy only, survival |
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