{"title":"胃肠道弥漫性大b细胞淋巴瘤的部位和分期治疗策略。","authors":"Yu Yagi, Yusuke Kanemasa, Yuki Sasaki, Mariko Matsubayashi, Yasuhiko Yamamura, Kaho Fujino, Takahiro Kuga, Nozomi Kanai, Yusuke Masuda, Kumiko Fujita, Kento Ishimine, Yudai Hayashi, Mano Mino, Ai Takahara, Taichi Tamura, Shohei Nakamura, Toshihiro Okuya, Shinichiro Matsuda, Takuya Shimizuguchi, Haruhiko Cho, Kazushige Kawai, Tatsu Shimoyama","doi":"10.1111/ejh.14440","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Although gastrointestinal diffuse large B-cell lymphoma (GI-DLBCL) is managed variously, the optimal approach remains controversial.</p><p><strong>Methods: </strong>We retrospectively analyzed 701 patients with DLBCL at our institution between March 2004 and June 2024, including 160 with GI-DLBCL. We compared baseline characteristics and survival outcomes of GI-DLBCL with non-GI-DLBCL and further analyzed gastric and intestinal DLBCL by stage.</p><p><strong>Results: </strong>No significant difference in survival outcomes was observed between GI and non-GI DLBCL groups after a median follow-up of 5.1 years. Among patients with gastric DLBCL, advanced disease was associated with poorer overall survival (OS) (hazard ratio [HR]: 1.75; 95% confidence interval [CI]: 1.18-2.58; p = 0.003) than localized disease. Similar findings were observed in intestinal DLBCL (HR: 1.60; 95% CI: 1.13-2.27; p = 0.006). Combined chemoradiation and chemotherapy yielded similar survival outcomes for localized gastric DLBCL although the former showed a higher cumulative incidence of secondary gastric cancer (p = 0.04). In localized intestinal DLBCL, multivariate analysis identified surgery followed by chemotherapy as a favorable prognostic factor for OS (HR: 0.23; 95% CI: 0.067-0.83; p = 0.024).</p><p><strong>Conclusions: </strong>Gastrointestinal diffuse large B-cell lymphoma had survival outcomes comparable to those of non-GI-DLBCL, suggesting site- and stage-specific therapies may confer a survival benefit.</p>","PeriodicalId":11955,"journal":{"name":"European Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Site- and Stage-Adapted Treatment Strategies for Gastrointestinal Diffuse Large B-Cell Lymphoma.\",\"authors\":\"Yu Yagi, Yusuke Kanemasa, Yuki Sasaki, Mariko Matsubayashi, Yasuhiko Yamamura, Kaho Fujino, Takahiro Kuga, Nozomi Kanai, Yusuke Masuda, Kumiko Fujita, Kento Ishimine, Yudai Hayashi, Mano Mino, Ai Takahara, Taichi Tamura, Shohei Nakamura, Toshihiro Okuya, Shinichiro Matsuda, Takuya Shimizuguchi, Haruhiko Cho, Kazushige Kawai, Tatsu Shimoyama\",\"doi\":\"10.1111/ejh.14440\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Although gastrointestinal diffuse large B-cell lymphoma (GI-DLBCL) is managed variously, the optimal approach remains controversial.</p><p><strong>Methods: </strong>We retrospectively analyzed 701 patients with DLBCL at our institution between March 2004 and June 2024, including 160 with GI-DLBCL. We compared baseline characteristics and survival outcomes of GI-DLBCL with non-GI-DLBCL and further analyzed gastric and intestinal DLBCL by stage.</p><p><strong>Results: </strong>No significant difference in survival outcomes was observed between GI and non-GI DLBCL groups after a median follow-up of 5.1 years. Among patients with gastric DLBCL, advanced disease was associated with poorer overall survival (OS) (hazard ratio [HR]: 1.75; 95% confidence interval [CI]: 1.18-2.58; p = 0.003) than localized disease. Similar findings were observed in intestinal DLBCL (HR: 1.60; 95% CI: 1.13-2.27; p = 0.006). Combined chemoradiation and chemotherapy yielded similar survival outcomes for localized gastric DLBCL although the former showed a higher cumulative incidence of secondary gastric cancer (p = 0.04). In localized intestinal DLBCL, multivariate analysis identified surgery followed by chemotherapy as a favorable prognostic factor for OS (HR: 0.23; 95% CI: 0.067-0.83; p = 0.024).</p><p><strong>Conclusions: </strong>Gastrointestinal diffuse large B-cell lymphoma had survival outcomes comparable to those of non-GI-DLBCL, suggesting site- and stage-specific therapies may confer a survival benefit.</p>\",\"PeriodicalId\":11955,\"journal\":{\"name\":\"European Journal of Haematology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-05-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Haematology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/ejh.14440\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Haematology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/ejh.14440","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
Site- and Stage-Adapted Treatment Strategies for Gastrointestinal Diffuse Large B-Cell Lymphoma.
Objectives: Although gastrointestinal diffuse large B-cell lymphoma (GI-DLBCL) is managed variously, the optimal approach remains controversial.
Methods: We retrospectively analyzed 701 patients with DLBCL at our institution between March 2004 and June 2024, including 160 with GI-DLBCL. We compared baseline characteristics and survival outcomes of GI-DLBCL with non-GI-DLBCL and further analyzed gastric and intestinal DLBCL by stage.
Results: No significant difference in survival outcomes was observed between GI and non-GI DLBCL groups after a median follow-up of 5.1 years. Among patients with gastric DLBCL, advanced disease was associated with poorer overall survival (OS) (hazard ratio [HR]: 1.75; 95% confidence interval [CI]: 1.18-2.58; p = 0.003) than localized disease. Similar findings were observed in intestinal DLBCL (HR: 1.60; 95% CI: 1.13-2.27; p = 0.006). Combined chemoradiation and chemotherapy yielded similar survival outcomes for localized gastric DLBCL although the former showed a higher cumulative incidence of secondary gastric cancer (p = 0.04). In localized intestinal DLBCL, multivariate analysis identified surgery followed by chemotherapy as a favorable prognostic factor for OS (HR: 0.23; 95% CI: 0.067-0.83; p = 0.024).
Conclusions: Gastrointestinal diffuse large B-cell lymphoma had survival outcomes comparable to those of non-GI-DLBCL, suggesting site- and stage-specific therapies may confer a survival benefit.
期刊介绍：
European Journal of Haematology is an international journal for communication of basic and clinical research in haematology. The journal welcomes manuscripts on molecular, cellular and clinical research on diseases of the blood, vascular and lymphatic tissue, and on basic molecular and cellular research related to normal development and function of the blood, vascular and lymphatic tissue. The journal also welcomes reviews on clinical haematology and basic research, case reports, and clinical pictures.
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