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Article: Prognostic factors for primary gastrointestinal lymphoma

TitlePrognostic factors for primary gastrointestinal lymphoma
Authors
Issue Date1995
PublisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/3182
Citation
Hematological Oncology, 1995, v. 13 n. 3, p. 153-163 How to Cite?
AbstractThe gastrointestinal tract is a common primary extranodal site for non-Hodgkin's lymphoma. There is however no uniform consensus on its pathological classification, clinical staging system and management. This paper reports the experience in the management of 425 Chinese patients with primary gastrointestinal lymphoma in Hong Kong from January 1975 to June 1993. There were 230 (54 per cent) males and 195 (46 per cent) females. Their median age was 53 years. The primary sites were: the esophagus in three (1 per cent), stomach in 238 (56 per cent), small intestine in 131 (31 per cent) and large intestine in 53 (12 per cent). According to the Working Formulation, there were 20 (4.7 per cent) small lymphocytic 10 (2.4 per cent) follicular small cleaved cell, 15 (3.5 per cent) follicular mixed, five (12 per cent) follicular large cell, 40 (9.4 per cent) diffuse small cleaved cell, 50 (12 per cent) diffuse mixed, 181 (43 per cent) diffuse large cell, 30 (7.1 per cent) immunoblastic, five (1.2 per cent) lymphoblastic, 10 (2.4 per cent) diffuse small non-cleaved cell and 50 (14 per cent) unclassifiable lymphoma. Immunophenotyping was performed in 199 (47 per cent) patients: 90 per cent B-cell, 7 per cent T-cell and 3 per cent uncertain. According to a Manchester system, 81 (19 per cent) patients had stage I disease, 44 (10 per cent) stage II, 85 (20 per cent) stage III and 215 (51 per cent) stage IV. B symptoms were present in 275 (65 per cent) patients and bulky disease in 104 (25 per cent). Surgery followed by chemotherapy was the mainstay of treatment. Of the 408 patients treated, 63 per cent had a complete remission with relapse rate of 42 per cent. For those with complete remission, 47 per cent were free from disease at 5 years. The overall median survival of all patient was 45 per cent at 5 years. Multivariate analysis revealed that significant independent prognostic factors predicting better survival were young age of <60 years, low grade histology, stage I and II disease and absence of bulky tumour. For gastric lymphoma, aggressive surgery did not significantly improve their outcome. Chemotherapy appears to play an important role in the management of gastrointestinal lymphoma. Better classification of the primary gastrointestinal lymphoma and more refined stratification of the patients according to the prognostic variables may allow individualization of treatment. Prospective randomized studies are essential to define the relative roles of surgery, chemotherapy and radiotherapy.
Persistent Identifierhttp://hdl.handle.net/10722/77550
ISSN
2015 Impact Factor: 3.494
2015 SCImago Journal Rankings: 0.767
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLiang, Ren_HK
dc.contributor.authorTodd, Den_HK
dc.contributor.authorChan, TKen_HK
dc.contributor.authorChiu, Een_HK
dc.contributor.authorLie, Aen_HK
dc.contributor.authorKwong, YLen_HK
dc.contributor.authorChoy, Den_HK
dc.contributor.authorHo, FCSen_HK
dc.date.accessioned2010-09-06T07:33:07Z-
dc.date.available2010-09-06T07:33:07Z-
dc.date.issued1995en_HK
dc.identifier.citationHematological Oncology, 1995, v. 13 n. 3, p. 153-163en_HK
dc.identifier.issn0278-0232en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77550-
dc.description.abstractThe gastrointestinal tract is a common primary extranodal site for non-Hodgkin's lymphoma. There is however no uniform consensus on its pathological classification, clinical staging system and management. This paper reports the experience in the management of 425 Chinese patients with primary gastrointestinal lymphoma in Hong Kong from January 1975 to June 1993. There were 230 (54 per cent) males and 195 (46 per cent) females. Their median age was 53 years. The primary sites were: the esophagus in three (1 per cent), stomach in 238 (56 per cent), small intestine in 131 (31 per cent) and large intestine in 53 (12 per cent). According to the Working Formulation, there were 20 (4.7 per cent) small lymphocytic 10 (2.4 per cent) follicular small cleaved cell, 15 (3.5 per cent) follicular mixed, five (12 per cent) follicular large cell, 40 (9.4 per cent) diffuse small cleaved cell, 50 (12 per cent) diffuse mixed, 181 (43 per cent) diffuse large cell, 30 (7.1 per cent) immunoblastic, five (1.2 per cent) lymphoblastic, 10 (2.4 per cent) diffuse small non-cleaved cell and 50 (14 per cent) unclassifiable lymphoma. Immunophenotyping was performed in 199 (47 per cent) patients: 90 per cent B-cell, 7 per cent T-cell and 3 per cent uncertain. According to a Manchester system, 81 (19 per cent) patients had stage I disease, 44 (10 per cent) stage II, 85 (20 per cent) stage III and 215 (51 per cent) stage IV. B symptoms were present in 275 (65 per cent) patients and bulky disease in 104 (25 per cent). Surgery followed by chemotherapy was the mainstay of treatment. Of the 408 patients treated, 63 per cent had a complete remission with relapse rate of 42 per cent. For those with complete remission, 47 per cent were free from disease at 5 years. The overall median survival of all patient was 45 per cent at 5 years. Multivariate analysis revealed that significant independent prognostic factors predicting better survival were young age of <60 years, low grade histology, stage I and II disease and absence of bulky tumour. For gastric lymphoma, aggressive surgery did not significantly improve their outcome. Chemotherapy appears to play an important role in the management of gastrointestinal lymphoma. Better classification of the primary gastrointestinal lymphoma and more refined stratification of the patients according to the prognostic variables may allow individualization of treatment. Prospective randomized studies are essential to define the relative roles of surgery, chemotherapy and radiotherapy.en_HK
dc.languageengen_HK
dc.publisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/3182en_HK
dc.relation.ispartofHematological Oncologyen_HK
dc.rightsHematological Oncology. Copyright © John Wiley & Sons Ltd.en_HK
dc.subject.meshAdulten_HK
dc.subject.meshAge Factorsen_HK
dc.subject.meshAgeden_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshGastrointestinal Neoplasms - mortality - pathology - therapyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshLymphoma, Non-Hodgkin - mortality - pathology - therapyen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshMultivariate Analysisen_HK
dc.subject.meshPrognosisen_HK
dc.subject.meshSurvival Analysisen_HK
dc.titlePrognostic factors for primary gastrointestinal lymphomaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0278-0232&volume=13&issue=3&spage=153&epage=164&date=1995&atitle=Prognostic+factors+for+primary+gastrointestinal+lymphomaen_HK
dc.identifier.emailLiang, R:rliang@hku.hken_HK
dc.identifier.emailKwong, YL:ylkwong@hku.hken_HK
dc.identifier.authorityLiang, R=rp00345en_HK
dc.identifier.authorityKwong, YL=rp00358en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/hon.2900130305en_HK
dc.identifier.pmid7622145-
dc.identifier.scopuseid_2-s2.0-0029063035en_HK
dc.identifier.hkuros8771en_HK
dc.identifier.volume13en_HK
dc.identifier.issue3en_HK
dc.identifier.spage153en_HK
dc.identifier.epage163en_HK
dc.identifier.isiWOS:A1995RJ43200004-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridLiang, R=26643224900en_HK
dc.identifier.scopusauthoridTodd, D=7201388182en_HK
dc.identifier.scopusauthoridChan, TK=7402687762en_HK
dc.identifier.scopusauthoridChiu, E=24827833600en_HK
dc.identifier.scopusauthoridLie, A=24284842400en_HK
dc.identifier.scopusauthoridKwong, YL=7102818954en_HK
dc.identifier.scopusauthoridChoy, D=8663654500en_HK
dc.identifier.scopusauthoridHo, FCS=7103408147en_HK

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