Published online Aug 15, 2022. doi: 10.4251/wjgo.v14.i8.1552
Peer-review started: November 27, 2021
First decision: January 23, 2022
Revised: January 19, 2022
Accepted: July 26, 2022
Article in press: July 26, 2022
Published online: August 15, 2022
Duodenal-type follicular lymphoma (D-FL) has been recognized as a rare primary gastrointestinal lymphoma. Because D-FL follows an indolent clinical course compared to nodal FL, the “watch and wait” approach is currently the general follow-up policy.
There is still insufficient consensus regarding the appropriate treatment of D-FL, and an option to actively treat D-FL is available. The long-term outcomes following the active treatment of D-FL are poorly understood.
This study aimed to clarify the clinical outcomes through long-term follow-up in cases of D-FL with treatment intervention.
We retrospectively examined 5 D-FL patients who underwent therapeutic intervention at our center from January 1998 to December 2009 and followed the clinical course of these patients for more than 10 years.
As a result of therapeutic intervention, all 5 cases reached complete remission (CR) and survived for more than 10 years. However, 3 of these cases experienced recurrence. One patient achieved a second CR after retreatment, and in the other case, the lesion spontaneously disappeared. The remaining patient experienced widespread systemic recurrence 13 years after the first CR. This patient died 4 years later despite treatment with various anticancer chemotherapies.
Five patients with D-FL who received treatment interventions regardless of clinical stage were evaluated with respect to the therapeutic effects of the treatment. Because fatal recurrence was found to occur even 13 years after the first CR, it is necessary to continue whole-body follow-up examinations for individuals diagnosed with D-FL.
Only 5 cases were examined in this study. By including more D-FL patients and evaluating their treatment, criteria for how to treat Stage IV “advanced” cases can be explored.