Annals of Oncology 10:1433-1440, 1999
© 1999 European Society for Medical Oncology
research-article |
Stage-modified international prognostic index effectively predicts clinical outcome of localized primary gastric diffuse large B-cell lymphoma
1Divisione di Ematologia, Ospedalt Riunitt di Bergamo Italy
2Istituto Oncologico delta Svizzera Italiana, Divisione di Oncologia Medica, Ospedale ‘S Giovanni’ Bellinzona, Switzerland
3Istituto dei Tumori Milano
4Cattedra di Ematologia ed Oncologia Medica, Università di Verona Varese
5Oncologia, Ospedale ‘Circolo Fondazione Macchi’ Varese
6U.O.A. Ematologia, Dipartimento di Oncologia, Azienda Ospedaliera ‘S.Giovanni Battista’ Torino
7Divisione di Radioterapia, Ospedale ‘Umberto I’ Mestre
8Oncologia, Ospedale ‘Infermi’ Rimini, Italy
Correspondence to: S. Cortelazzo. MD, Department of Hematology, Ospedali Riuniti di Bergamo, Largo Barozzi 1, 24128 Bergamo, Italy. E-mail: ematologia{at}cyberg.it
Background: The definition of prognostic parameters in early stages of gastric lymphoma is still controversial. The aim of this retrospective analysis was to assess the value of the stage-modified international prognostic index (IPI) in predicting the outcome of a large, consecutive series of patients with PGL of diffuse large B-cell histology (DLCL).
Patients and methods: Three hundred twelve consecutive, newly-diagnosed, patients with localized PGL (stages I–IIE according to the ‘Lugano staging system for GI lymphomas’) referred from April 1972 to December 1997 to eight Italian and one Swiss centers were reviewed and their outcomes updated to June 1998. One hundred three patients were treated with single-modality therapy, while two hundred four received combined-modality treatment, most of which included surgery and short-term chemotherapy.
Results: After a median follow-up of 66 months (range 0.6–300 months), 195 (64%) were alive in first continuous complete remission (CCR). The five-year estimates of overall survival (OS) and event-free survival (EFS) were 75% and 67%, respectively. OS and EFS varied according to IPI, from, respectively, 90% and 82% for patients with 0–1 risk factors, to 40% and 35% for patients with 
3 risk factors (P = 0.00001). Cox regression analysis showed that IPI was the strongest predictor of survival.
Conclusions: This study shows that stage-modified IPI is an effective predictive model in patients with primary DLCL of the stomach, enabling identification of patients with significantly different outcomes.
combined-modality treatment, DLCL, PGL, stage-modified IPI
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