Intestinal diffuse large B-cell lymphoma: an evaluation of different staging systems

Area of Science:

• Gastrointestinal Oncology
• Hematologic Malignancies
• Clinical Staging Systems

Background:

• The gastrointestinal tract is a frequent primary extranodal site for diffuse large B-cell lymphoma (DLBCL).
• Current staging systems lack consensus for intestinal DLBCL, impacting treatment decisions.
• Accurate staging is crucial for predicting prognosis in intestinal DLBCL.

Purpose of the Study:

• To evaluate the prognostic utility of the modified Ann Arbor, Lugano, and Paris staging systems for intestinal DLBCL.
• To compare the effectiveness of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) chemotherapy with and without rituximab in resected intestinal DLBCL.

Main Methods:

• Retrospective analysis of 66 resected intestinal DLBCL cases.
• Application and comparison of modified Ann Arbor, Lugano, and Paris staging systems.
• Univariate and multivariate survival analyses were performed.

Main Results:

• The T stage of the Paris classification demonstrated prognostic significance for overall survival in univariate analysis.
• No staging parameters showed significant correlation with patient survival in multivariate analysis.
• Addition of rituximab to CHOP chemotherapy did not significantly improve survival in this cohort.

Conclusions:

• The T stage of the Paris classification may serve as a prognostic indicator for intestinal DLBCL.
• Current staging systems require further refinement for intestinal DLBCL.
• Rituximab may not offer a survival benefit in all cases of resected intestinal DLBCL when added to CHOP.