Complications and outcomes in diffuse large B‐cell lymphoma with gastric lesions treated with R‐CHOP
Abstract Standard therapy for gastric diffuse large B‐cell lymphoma (DLBCL) is considered to be chemotherapy with or without involved‐field radiation therapy. Although R‐CHOP therapy alone is widely used for DLBCL with gastric lesions (DLBCL‐GL), the outcome and incidence of treatment‐related gastri...
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| Format: | Article |
| Language: | English |
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Wiley
2019-03-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.1982 |
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| author | Tomohiro Kadota Sachiko Seo Hiroe Fuse Genichiro Ishii Kuniaki Itoh Tomonori Yano Kazuhiro Kaneko Kunihiro Tsukasaki |
| author_facet | Tomohiro Kadota Sachiko Seo Hiroe Fuse Genichiro Ishii Kuniaki Itoh Tomonori Yano Kazuhiro Kaneko Kunihiro Tsukasaki |
| author_sort | Tomohiro Kadota |
| collection | DOAJ |
| description | Abstract Standard therapy for gastric diffuse large B‐cell lymphoma (DLBCL) is considered to be chemotherapy with or without involved‐field radiation therapy. Although R‐CHOP therapy alone is widely used for DLBCL with gastric lesions (DLBCL‐GL), the outcome and incidence of treatment‐related gastric complications following R‐CHOP are not well known. This study aimed to evaluate the outcome after R‐CHOP therapy in patients with gastric DLBCL including gastric complications and to identify risk factors for the complications. Consecutive patients with newly diagnosed DLBCL‐GL treated with R‐CHOP between 2003 and 2014 were retrospectively evaluated. DLBCL‐GL was defined only when pathologically confirmed in the stomach. Of the 96 patients with DLBCL‐GL, 63 patients were diagnosed with gastric symptoms. Eighty‐eight patients (92%) completed six to eight cycles of R‐CHOP. The complete remission (CR) rate was 86%, and 3‐year and 5‐year overall survival rates were 80% and 73%, respectively. Patients were well stratified according to the Revised International Prognostic Index (R‐IPI). Complication rate was 8% (8/96); seven patients had bleeding and three had stenosis. No patients had gastric perforation. Bleeding occurred during the first cycle of R‐CHOP in five patients (5/7, 71%). Patients with gastric complications had a lower R‐CHOP completion rate (50%, P = 0.001) and a lower CR rate (25%, P < 0.001) than those without complications. A low serum albumin level at diagnosis was the only risk factor identified for gastric complications (P = 0.001) and six of the eight patients with complications were shown to be at stage IV. Further studies of DLBCL‐GL are warranted to identify patients at high risk for gastric complications and to provide better treatment strategies. |
| format | Article |
| id | doaj-art-082cb337a06645a69398e0a00c19e34d |
| institution | Kabale University |
| issn | 2045-7634 |
| language | English |
| publishDate | 2019-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-082cb337a06645a69398e0a00c19e34d2025-01-31T08:47:42ZengWileyCancer Medicine2045-76342019-03-018398298910.1002/cam4.1982Complications and outcomes in diffuse large B‐cell lymphoma with gastric lesions treated with R‐CHOPTomohiro Kadota0Sachiko Seo1Hiroe Fuse2Genichiro Ishii3Kuniaki Itoh4Tomonori Yano5Kazuhiro Kaneko6Kunihiro Tsukasaki7Department of Gastroenterology, Endoscopy Division National Cancer Center Hospital East Kashiwa JapanDepartment of Hematology National Cancer Center Hospital East Kashiwa JapanDepartment of Hematology Matsudo City General Hospital Matsudo Chiba JapanDivision of Pathology, Exploratory Oncology Research & Clinical Trial Center (EPOC) National Cancer Center Kashiwa Chiba JapanDepartment of Hematology National Cancer Center Hospital East Kashiwa JapanDepartment of Gastroenterology, Endoscopy Division National Cancer Center Hospital East Kashiwa JapanDepartment of Gastroenterology, Endoscopy Division National Cancer Center Hospital East Kashiwa JapanDepartment of Hematology National Cancer Center Hospital East Kashiwa JapanAbstract Standard therapy for gastric diffuse large B‐cell lymphoma (DLBCL) is considered to be chemotherapy with or without involved‐field radiation therapy. Although R‐CHOP therapy alone is widely used for DLBCL with gastric lesions (DLBCL‐GL), the outcome and incidence of treatment‐related gastric complications following R‐CHOP are not well known. This study aimed to evaluate the outcome after R‐CHOP therapy in patients with gastric DLBCL including gastric complications and to identify risk factors for the complications. Consecutive patients with newly diagnosed DLBCL‐GL treated with R‐CHOP between 2003 and 2014 were retrospectively evaluated. DLBCL‐GL was defined only when pathologically confirmed in the stomach. Of the 96 patients with DLBCL‐GL, 63 patients were diagnosed with gastric symptoms. Eighty‐eight patients (92%) completed six to eight cycles of R‐CHOP. The complete remission (CR) rate was 86%, and 3‐year and 5‐year overall survival rates were 80% and 73%, respectively. Patients were well stratified according to the Revised International Prognostic Index (R‐IPI). Complication rate was 8% (8/96); seven patients had bleeding and three had stenosis. No patients had gastric perforation. Bleeding occurred during the first cycle of R‐CHOP in five patients (5/7, 71%). Patients with gastric complications had a lower R‐CHOP completion rate (50%, P = 0.001) and a lower CR rate (25%, P < 0.001) than those without complications. A low serum albumin level at diagnosis was the only risk factor identified for gastric complications (P = 0.001) and six of the eight patients with complications were shown to be at stage IV. Further studies of DLBCL‐GL are warranted to identify patients at high risk for gastric complications and to provide better treatment strategies.https://doi.org/10.1002/cam4.1982bleedingdiffuse large B‐cell lymphoma with gastric lesionsgastric complicationsmortalityR‐CHOP |
| spellingShingle | Tomohiro Kadota Sachiko Seo Hiroe Fuse Genichiro Ishii Kuniaki Itoh Tomonori Yano Kazuhiro Kaneko Kunihiro Tsukasaki Complications and outcomes in diffuse large B‐cell lymphoma with gastric lesions treated with R‐CHOP Cancer Medicine bleeding diffuse large B‐cell lymphoma with gastric lesions gastric complications mortality R‐CHOP |
| title | Complications and outcomes in diffuse large B‐cell lymphoma with gastric lesions treated with R‐CHOP |
| title_full | Complications and outcomes in diffuse large B‐cell lymphoma with gastric lesions treated with R‐CHOP |
| title_fullStr | Complications and outcomes in diffuse large B‐cell lymphoma with gastric lesions treated with R‐CHOP |
| title_full_unstemmed | Complications and outcomes in diffuse large B‐cell lymphoma with gastric lesions treated with R‐CHOP |
| title_short | Complications and outcomes in diffuse large B‐cell lymphoma with gastric lesions treated with R‐CHOP |
| title_sort | complications and outcomes in diffuse large b cell lymphoma with gastric lesions treated with r chop |
| topic | bleeding diffuse large B‐cell lymphoma with gastric lesions gastric complications mortality R‐CHOP |
| url | https://doi.org/10.1002/cam4.1982 |
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