Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Aug 15, 2022; 14(8): 1552-1561
Published online Aug 15, 2022. doi: 10.4251/wjgo.v14.i8.1552
Duodenal-type follicular lymphoma more than 10 years after treatment intervention: A retrospective single-center analysis
Makoto Saito, Akio Mori, Shihori Tsukamoto, Takashi Ishio, Emi Yokoyama, Koh Izumiyama, Masanobu Morioka, Takeshi Kondo, Hirokazu Sugino
Makoto Saito, Akio Mori, Shihori Tsukamoto, Takashi Ishio, Emi Yokoyama, Koh Izumiyama, Masanobu Morioka, Takeshi Kondo, Blood Disorders Center, Aiiku Hospital, Sapporo 064-0804, Japan
Hirokazu Sugino, Department of Cancer Pathology, Hokkaido University, Faculty of Medicine, Sapporo 060-8638, Japan
Author contributions: Saito M designed this study; Mori A, Tsukamoto S, Ishio T, Yokoyama E, Izumiyama K, Morioka M, and Kondo T took part in drafting the article; Sugino H was involved in the pathological procedure; all authors collected and analyzed the patient’s clinical data and agreed to be accountable for all aspects of the work.
Institutional review board statement: This study was reviewed and approved by the Aiiku Hospital Clinical Research Review Board (Sapporo).
Informed consent statement: All patients provided written informed consent.
Conflict-of-interest statement: There are no conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Makoto Saito, MD, PhD, Chief Doctor, Blood Disorders Center, Aiiku Hospital, Chuo-ku, 4 Minami 25 Nishi, Sapporo 064-0804, Japan. ikyoku@aiiku-hp.or.jp
Received: November 27, 2021
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
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

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.

Research objectives

This study aimed to clarify the clinical outcomes through long-term follow-up in cases of D-FL with treatment intervention.

Research methods

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.

Research results

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.

Research conclusions

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.

Research perspectives

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.