Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2021; 9(31): 9417-9430
Published online Nov 6, 2021. doi: 10.12998/wjcc.v9.i31.9417
Clinical management and susceptibility of primary hepatic lymphoma: A cases-based retrospective study
Tao Hai, Li-Qun Zou
Tao Hai, Cancer Center, West China Hospital, Chengdu 610041, Sichuan Province, China
Li-Qun Zou, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Hai T designed and performed the research, wrote the paper, contributed to the analysis; Zou LQ designed the research, supervised the report, and provided clinical advice.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee on Biomedical Research, West China Hospital of Sichuan University.
Informed consent statement: The ethics committee waived the need for written informed consent.
Conflict-of-interest statement: The authors have no financial relationships to disclose.
Data sharing statement: No additional data are available.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Qun Zou, MD, PhD, Chief Doctor, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, Sichuan Province, China. zliqun@hotmail.com
Received: March 31, 2021
Peer-review started: April 1, 2021
First decision: August 18, 2021
Revised: August 21, 2021
Accepted: September 14, 2021
Article in press: September 14, 2021
Published online: November 6, 2021
Processing time: 212 Days and 0.3 Hours
Abstract
BACKGROUND

The liver as a primary site of lymphoma is rarely seen, they are usually misdiagnosed as hepatocellular carcinoma, etc. In 2017, a review of primary hepatic lymphoma (PHL) was done in immunocompetent diffuse large B-cell lymphoma (DLBCL) patients. Yet questions that include treatment choosing or susceptibility of immunoincompetent patients remain disputable.

AIM

To investigate the clinical characteristics of patients with PHL.

METHODS

We collected PHL cases on PubMed, and extracted demographic and clinicopathological data to perform a systematic analysis. Survival analysis regarding age, lactate dehydrogenase (LDH), liver function abnormality (LFA), and treatment modalities were conducted. The Kaplan-Meier method and Cox regression were used to identify risk factors.

RESULTS

Of 116 PHL patients with DLBCL (62.1%) as the most common subtype. Biopsy methods before surgery produced a 97% positive rate. Progression-free survival (PFS) was significantly shortened in patients with elevated LDH [Hazard ratio (HR): 3.076, 95% confidence interval (CI): 1.207-7.840, P = 0.018] or LFA (HR: 2.909, 95%CI: 1.135-7.452, P = 0.026). Univariate Cox regression analysis suggesting that LDH, liver function, B symptom, hepatosplenomegaly, and lesion were significantly associated with PHL patients survival (P < 0.05). Heavy disease burden was observed in deceased patients. A few PHL patients (3.4%) have slightly higher tumor markers.

CONCLUSION

PHL patients with elevated LDH and LFA tend to have shorter PFS. Biopsy before treatment in undecided patients with no tumor markers exceeds upper limits has the most essential clinical significance, especially in immunoincompetent patients.

Keywords: Primary hepatic lymphoma; Misdiagnosis; Biopsy; Retrospective study

Core Tip: Primary hepatic lymphoma is rarely seen in clinical work, mostly presented with a liver mass discovered by a radiography or imaging test, and usually been misdiagnosed as other hepatic malignancies. In our study, we discovered that patients with elevated lactate dehydrogenase and liver functions abnormality tend to have shorter progression-free survival, and biopsy before treatment along normal tumor markers has most essential clinical significance, and immunoincompetent patients were must susceptible to this aliment.