Abstract
Treatment modalities for primary gastric diffuse large B-cell lymphoma (PG-DLBCL) have changed significantly during the past decades. However, limited information on the trends of clinical outcome of PG-DLBCL patients has been reported. Here, we conducted a retrospective analysis using the Surveillance, Epidemiology, and End Results (SEER) database to compare the survival trends of PG-DLBCL patients from 1973 to 2014. Patients were divided into 2 eras based on the year of diagnosis in relation to immunotherapy with the anti-CD20 antibody rituximab that was approved in 1997 and became a widely used drug in 2000. There was a significant improvement in survival among PG-DLBCL patients diagnosed in the 2001–2014 era (n = 4186) compared to patients diagnosed in the 1973–2000 era (n = 2865), with the 5-year overall survival rates of 53% and 47%, respectively (p = 0.001). Multivariable analysis revealed that the 2001–2014 era (HR = 0.892, p = 0.001) was associated with lower mortality and that patients of older age, Black race, advanced stage, and male gender were associated with poor prognosis. Although outcome of PG-DLBCL has significantly improved over time, more effective therapies are needed for older patients to further improve their survival.
Highlights
Primary gastric diffuse large B-cell lymphoma (PG-DLBCL) is the most common extranodal non-Hodgkin lymphomas (NHLs) [1]
With the recent advancement in diagnostic technique, the availability of more aggressive chemotherapy regimens, and the concern on the complications caused by gastric resection, surgery has been replaced by chemotherapy and radiotherapy in the treatment of PG-DLBCL
From 1973 to 2014, a total of 7051 PG-DLBCL patients were registered in the SEER database
Summary
Primary gastric diffuse large B-cell lymphoma (PG-DLBCL) is the most common extranodal non-Hodgkin lymphomas (NHLs) [1]. Patients with this type of lymphoma tend to present at limited stage and have a relative favorable prognosis [2, 3]. Several investigators even suggested that surgery should be omitted as they found the overall survival (OS) of the nonsurgical group was not inferior to that of the surgical group [1, 3, 7] Their observations suggest that chemotherapy in combination with or without radiation may be preferred
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