Background: The management of primary intestinal diffuse large B cell lymphoma (PI-DLBCL) in elderly patients (aged > 60 years) remains controversial. We conducted a retrospective study to assess the efficacy of different treatment strategies and prognostic factors for elderly Chinese patients with PI-DLBCL.
Patients and Methods: Forty-six untreated elderly patients with PI-DLBCL were included in this retrospective study. Twenty-four patients were treated with surgery (prior to chemotherapy) plus chemotherapy (SCT). The other 22 patients did not undergo surgery before chemotherapy (CT).
Results: Patients treated with SCT had a higher overall response rate of 91.7% than patients receiving CT, but the difference between groups was not significant (P =0.581). Regarding survival, SCT resulted in a greater 3-year overall survival (OS) rate (87.3% vs 56.9%, P =0.130) and significantly higher 3-year event-free survival (EFS) rate (74.1% vs 27.3%, P =0.002) than CT. The univariate analysis showed that male sex, advanced Lugano stage, poor performance status and chemotherapy alone were associated with a shorter EFS. Only the male sex was correlated with a shorter OS. The multivariate analysis showed that sex (P =0.040) and treatment strategy (P =0.022) were independent prognostic factors for EFS.
Conclusion: Surgery plus chemotherapy produced a better outcome for EFS, but not OS, than chemotherapy alone in elderly Chinese patients with PI-DLBCL.
Keywords: PI-DLBCL, surgery, chemotherapy, survival, prognostic factors