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Related Concept Videos

Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies01:28

Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies

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Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
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Primary gastric diffuse large B-cell lymphoma: A multicentre retrospective study.

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  • 1Department of Haematology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.

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|April 18, 2024
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Summary

Early-stage gastric diffuse large B-cell lymphoma (DLBCL) shows favorable outcomes with R-CHOP chemoimmunotherapy. Interim PET scans accurately predict treatment response, guiding further management for localized DLBCL.

Keywords:
DLBCLextranodal lymphomagastric DLBCLgastric lymphoma

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Area of Science:

  • Oncology
  • Hematology
  • Medical Imaging

Background:

  • Primary gastric diffuse large B-cell lymphoma (PG-DLBCL) is the most common extranodal DLBCL subtype.
  • Limited literature exists on early-stage, localized PG-DLBCL presentations and outcomes.
  • Understanding treatment efficacy and prognostic factors is crucial for this patient group.

Purpose of the Study:

  • To characterize outcomes in patients with stage I PG-DLBCL.
  • To review current treatment strategies for early-stage PG-DLBCL.
  • To investigate the role of interim positron emission tomography (iPET) in predicting treatment response.

Main Methods:

  • Retrospective analysis of 37 patients with stage I PG-DLBCL diagnosed between 2006-2018 across six international centers.
  • Patients received chemoimmunotherapy, primarily R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone).
  • Consolidative radiotherapy and Helicobacter pylori (H. pylori) eradication therapy were assessed as adjuncts; iPET scans were reviewed.

Main Results:

  • The 4-year progression-free survival (PFS) and overall survival (OS) for R-CHOP were 88% and 91%, respectively.
  • All patients achieving a metabolic response on iPET achieved complete response at end of treatment.
  • Consolidative radiotherapy was used in 35.1% of patients; H. pylori status was documented in 18 patients.

Conclusions:

  • R-CHOP-based chemoimmunotherapy demonstrates favorable outcomes for stage I PG-DLBCL.
  • Interim PET (iPET) assessment is a valuable tool for predicting treatment response in early-stage gastric lymphoma.
  • Treatment decisions regarding radiotherapy and H. pylori eradication should be individualized.