Clinical management and outcomes of completely resected stage I follicular lymphoma

• Published in: Journal of Clinical and Experimental Hematopathology Vol. 58; no. 1; pp. 10 - 16
• Main Authors: Yokohama, Akihiko, Hashimoto, Yoko, Takizawa, Makiko, Shimizu, Hiroaki, Miyazawa, Yuri, Saitoh, Akio, Toyama, Kohtaro, Ishizaki, Takuma, Mitsui, Takeki, Hiromi, Koiso, Saitoh, Takayuki, Murayama, Kayoko, Matsumoto, Morio, Sawamura, Morio, Murakami, Hirokazu, Hirato, Junko, Kojima, Masaru, Nojima, Yoshihisa, Handa, Hiroshi, Tsukamoto, Norifumi
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society for Lymphoreticular Tissue Research 01-01-2018; JSLRT
• Subjects: 18F-fluorodeoxyglucose PET; Aged; Disease-Free Survival; Female; follicular lymphoma; Glucose-6-Phosphate - administration & dosage; Glucose-6-Phosphate - analogs & derivatives; Humans; irradiation; Lymphoma, Follicular - diagnostic imaging; Lymphoma, Follicular - mortality; Lymphoma, Follicular - surgery; Male; Middle Aged; Neoplasm Staging; Neoplasm, Residual; Original; Positron-Emission Tomography; resected; Survival Rate; resected; follicular lymphoma; irradiation; 18F-fluorodeoxyglucose PET
• ISSN: 1346-4280; 1880-9952
• DOI: 10.3960/jslrt.17031

Recent studies have revealed the clinical and biological features of stage I follicular lymphoma (FL), but information about patients with stage I FL who underwent total resection after tissue biopsy is limited. Among 305 FL patients diagnosed between 2001 and 2013, clinical stage I disease was observed in 36 patients. Of these, 18 patients underwent total resection after diagnostic tissue biopsy. We used 18F-fluorodeoxyglucose positron emission CT for staging assessment in 13 of 18 patients (72.2%). The median age was 56.5 years. Six patients (33.3%) were male. The soluble interleukin-2 receptor alpha concentration was significantly lower than in patients with residual disease. Among these 18 patients, 7 patients (38.9%) were treated with a “watch-and-wait” (WW) policy, 7 (38.9%) were treated with involved-field irradiation, and 4 (22.2%) received systemic chemotherapy. Patients with resected disease were treated with significantly different strategies from those with residual disease (p = 0.0026). Five patients experienced relapse during follow-up (median follow-up: 48.2 months). All relapses were distant from the primary site, irrespective of treatment strategy. Among all stage I patients, disease resection was not a significant factor for survival (p = 0.9294). Collectively, the choice of treatment strategy was significantly influenced by patient status. Resection status was not significantly associated with survival after several treatment strategies.