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Site- and Stage-Adapted Treatment Strategies for Gastrointestinal Diffuse Large B-Cell Lymphoma
Yu Yagi1, Yusuke Kanemasa1, Yuki Sasaki1
1Department of Medical Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
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.
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