Philippe Prouet1,2, Smith Giri3, Eric Wiedower4,2, Andrew Fintel5, George Yaghmour6, Elena Paulus Lamb7, Jeremiah Deneve8, Martin Fleming8, Paxton Dickson8, Jason C Chandler4,2, Mike G Martin4,2. 1. The West Cancer Center, Germantown, TN, U.S.A. pprouet@westclinic.com. 2. University of Tennessee Health Science Center Hematology/Oncology, Memphis, TN, U.S.A. 3. Department of Medical Oncology, Yale School of Medicine, New Haven, CT, U.S.A. 4. The West Cancer Center, Germantown, TN, U.S.A. 5. Blue Ridge Cancer Center, Salem, VA, U.S.A. 6. Keck Hospital of USC, Los Angeles, CA, U.S.A. 7. Fox Chase Cancer Center, Temple Health, Philadelphia, PA, U.S.A. 8. Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, U.S.A.
Abstract
BACKGROUND: We evaluated surgical trends for gastric diffuse large B-cell lymphoma (gDLBCL) before and after the approval of rituximab and whether an association of early mortality existed in patients treated after approval of rituximab. PATIENTS AND METHODS: We utilized the Surveillance Epidemiology and End Results (SEER) 18 database to extract data on patients with gDLBCL diagnosed between 1983-2012. Primary site-specific cancer-directed surgery using SEER site-specific surgical codes and annual trends were analyzed. Patients were analyzed before and after 2006, the year rituximab gained U.S. Food and Drug Administration approval. RESULTS: Joinpoint trend analysis showed the sharpest decline in surgical rates between 2000-2010. Adjusted surgical rates computed using poisson regression declined from 54.4% in 1983 to 6.9% in 2012, with an annual percentage change of -8.9% (95% confidence interval=-9.7% to -8.3%; p-value <0.01). No significant mortality increase at 30 and 60 days was found. CONCLUSION: While rituximab appears to have significantly changed how surgery is utilized for patients with gDLBCL, early mortality was unchanged. Copyright
BACKGROUND: We evaluated surgical trends for gastric diffuse large B-cell lymphoma (gDLBCL) before and after the approval of rituximab and whether an association of early mortality existed in patients treated after approval of rituximab. PATIENTS AND METHODS: We utilized the Surveillance Epidemiology and End Results (SEER) 18 database to extract data on patients with gDLBCL diagnosed between 1983-2012. Primary site-specific cancer-directed surgery using SEER site-specific surgical codes and annual trends were analyzed. Patients were analyzed before and after 2006, the year rituximab gained U.S. Food and Drug Administration approval. RESULTS: Joinpoint trend analysis showed the sharpest decline in surgical rates between 2000-2010. Adjusted surgical rates computed using poisson regression declined from 54.4% in 1983 to 6.9% in 2012, with an annual percentage change of -8.9% (95% confidence interval=-9.7% to -8.3%; p-value <0.01). No significant mortality increase at 30 and 60 days was found. CONCLUSION: While rituximab appears to have significantly changed how surgery is utilized for patients with gDLBCL, early mortality was unchanged. Copyright