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dc.contributor.authorRyan, G
dc.contributor.authorMartinelli, Giovanni
dc.contributor.authorKuper-Hommel, M
dc.contributor.authorTsang, R
dc.contributor.authorPruneri, G
dc.contributor.authorYuen, K
dc.contributor.authorRoos, D
dc.contributor.authorLennard, A
dc.contributor.authorDevizzi, L
dc.contributor.authorCrabb, S
dc.contributor.authorHossfeld, D
dc.contributor.authorPratt, Guy
dc.contributor.authorDell'Olio, M
dc.contributor.authorChoo, S P
dc.contributor.authorBociek, R G
dc.contributor.authorRadford, John A
dc.contributor.authorLade, S
dc.contributor.authorGianni, A M
dc.contributor.authorZucca, E
dc.contributor.authorCavalli, Franco
dc.contributor.authorSeymour, J F
dc.date.accessioned2009-03-16T17:16:16Z
dc.date.available2009-03-16T17:16:16Z
dc.date.issued2008-02
dc.identifier.citationPrimary diffuse large B-cell lymphoma of the breast: prognostic factors and outcomes of a study by the International Extranodal Lymphoma Study Group. 2008, 19 (2):233-41 Ann. Oncol.en
dc.identifier.issn1569-8041
dc.identifier.pmid17932394
dc.identifier.doi10.1093/annonc/mdm471
dc.identifier.urihttp://hdl.handle.net/10541/55801
dc.description.abstractBACKGROUND: Primary diffuse large B-cell lymphoma (DLBCL) of breast is rare. We aimed to define clinical features, prognostic factors, patterns of failure, and treatment outcomes. PATIENTS AND METHODS: A retrospective international study of 204 eligible patients presenting to the International Extranodal Lymphoma Study Group-affiliated institutions from 1980 to 2003. RESULTS: Median age was 64 years, with 95% of patients presenting with unilateral disease. Median overall survival (OS) was 8.0 years, and median progression-free survival 5.5 years. In multifactor analysis, favourable International Prognostic Index score, anthracycline-containing chemotherapy, and radiotherapy (RT) were significantly associated with longer OS (each P < or = 0.03). There was no benefit from mastectomy, as opposed to biopsy or lumpectomy only. At a median follow-up time of 5.5 years, 37% of patients had progressed--16% in the same or contralateral breast, 5% in the central nervous system, and 14% in other extranodal sites. CONCLUSIONS: The combination of limited surgery, anthracycline-containing chemotherapy, and involved-field RT produced the best outcome in the pre-rituximab era. A prospective trial on the basis of these results should be pursued to confirm these observations and to determine whether the impact of rituximab on the patterns of relapse and outcome parallels that of DLBCL presenting at other sites.
dc.language.isoenen
dc.subjectAnthracyclin-Based Chemotherapyen
dc.subjectBreasten
dc.subjectLarge B-Cell Lymphomaen
dc.subjectRadiotherapyen
dc.subject.meshAdolescent
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshAged, 80 and over
dc.subject.meshBreast Neoplasms
dc.subject.meshCombined Modality Therapy
dc.subject.meshDisease-Free Survival
dc.subject.meshFemale
dc.subject.meshHumans
dc.subject.meshImmunohistochemistry
dc.subject.meshInternational Cooperation
dc.subject.meshLymphoma, Large B-Cell, Diffuse
dc.subject.meshMiddle Aged
dc.subject.meshMulticenter Studies as Topic
dc.subject.meshNeoplasm Recurrence, Local
dc.subject.meshNeoplasm Staging
dc.subject.meshProbability
dc.subject.meshPrognosis
dc.subject.meshRetrospective Studies
dc.subject.meshRisk Assessment
dc.subject.meshSocieties, Medical
dc.subject.meshSurvival Analysis
dc.titlePrimary diffuse large B-cell lymphoma of the breast: prognostic factors and outcomes of a study by the International Extranodal Lymphoma Study Group.en
dc.typeArticleen
dc.contributor.departmentPeter MacCallum Cancer Centre and University of Melbourne, Melbourne, Australia. gail.ryan@petermac.orgen
dc.identifier.journalAnnals of Oncologyen
html.description.abstractBACKGROUND: Primary diffuse large B-cell lymphoma (DLBCL) of breast is rare. We aimed to define clinical features, prognostic factors, patterns of failure, and treatment outcomes. PATIENTS AND METHODS: A retrospective international study of 204 eligible patients presenting to the International Extranodal Lymphoma Study Group-affiliated institutions from 1980 to 2003. RESULTS: Median age was 64 years, with 95% of patients presenting with unilateral disease. Median overall survival (OS) was 8.0 years, and median progression-free survival 5.5 years. In multifactor analysis, favourable International Prognostic Index score, anthracycline-containing chemotherapy, and radiotherapy (RT) were significantly associated with longer OS (each P < or = 0.03). There was no benefit from mastectomy, as opposed to biopsy or lumpectomy only. At a median follow-up time of 5.5 years, 37% of patients had progressed--16% in the same or contralateral breast, 5% in the central nervous system, and 14% in other extranodal sites. CONCLUSIONS: The combination of limited surgery, anthracycline-containing chemotherapy, and involved-field RT produced the best outcome in the pre-rituximab era. A prospective trial on the basis of these results should be pursued to confirm these observations and to determine whether the impact of rituximab on the patterns of relapse and outcome parallels that of DLBCL presenting at other sites.


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