Table 1 |
||||
|
Patient characteristics, treatment and outcomes |
||||
|
Case 1 |
Case 2 |
Case 3 |
Case 4 |
|
|
|
||||
|
Age |
64 |
70 |
56 |
61 |
|
Sex |
Male |
Male |
Male |
Male |
|
Presenting Symptoms |
Abdominal pain, nausea, weight loss then jaundice |
Vomiting, weight loss |
Dyspepsia, weight loss |
Abdominal pain, weight loss then jaundice |
|
Delay until diagnosis |
5 weeks |
3 months |
18 months |
4 months |
|
Method of diagnosis |
Endoscopic ultrasound FNA |
Laparotomy |
Laparotomy |
Laparotomy |
|
CT appearance |
6 cm pancreatic mass with biliary obstruction and portal vein involvement |
Large peri-pancreatic mass |
5 cm pancreatic mass |
Pancreatic mass and peripancreatic lymph nodes |
|
Ca-19.9 level* |
500 kU/L |
50 kU/L |
Not available |
39 kU/L |
|
Pre-treatment LDH |
Normal |
Elevated |
Normal |
Elevated |
|
Histology** |
DLBCL |
DLBCL |
Grade II follicular non-Hodgkins lymphoma |
DLBCL |
|
Stage*** |
IIE |
IIE |
IIE |
IIE |
|
Prognostic index |
Low-intermediate risk (IPI 2/5) |
Low-intermediate risk (IPI 2/5) |
Low risk (FLIPI 1/5) |
Low-intermediate risk (IPI 2/5) |
|
Treatment |
R-CHOP * 4 then involved-field RT |
CHOP * 3 then involved-field RT |
Involved-field RT then CVP then rituximab |
3 * CHOP then involved-field RT |
|
Outcome |
NED at 23 months |
Local recurrence at 32 months post-diagnosis, with poor tolerance of 2nd line chemotherapy and rapid treatment-related death |
NED at 25 months |
Out of field recurrence at 21 months post diagnosis. Salvage chemotherapy and autologous SCT. NED at 64 months from diagnosis |
|
|
||||
|
CHOP – Cyclophosphamide, doxorubicin, vincristine, prednisone CVP – Cyclophosphamide, vincristine, prednisone DLBCL – diffuse large B-cell non-Hodgkin's lymphoma FLIPI – Follicular lymphoma international prognostic index [8] IPI – International Prognostic Index for the Aggressive Non-Hodgkin's Lymphomas [7] NED – No evidence of disease R-CHOP – Rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone RT – Radiotherapy SCT – Stem cell transplantation * Normal Range 0–50 kU/L ** Histology defined according to REAL classification.[5] *** Staging defined according to Ann Arbor staging system.[4] |
||||
|
Grimison et al. BMC Cancer 2006 6:117 doi:10.1186/1471-2407-6-117 |
||||
