FREQUENCY OF PERFORATION & IMPACT OF BOWEL REST IN AGGRESSIVE NON‐HODGKIN LYMPHOMA WITH GASTROINTESTINAL INVOLVEMENT: AN INTERNATIONAL, MULTI‐CENTER RETROSPECTIVE STUDY
Bibliographic record
Abstract
Introduction: The gastrointestinal (GI) tract is involved in 10-15% of patients with newly diagnosed non-Hodgkin lymphoma (NHL) and can lead to perforation, peritonitis and death. Some physicians advocate admission for the first cycle of chemotherapy to facilitate early recognition and rapid surgical intervention. Others also employ bowel rest and prescribe total parenteral nutrition (TPN) to reduce peritoneal contamination in the event of perforation. However, it is unclear if these measures are effective. Methods: We performed a multi-centre, retrospective analysis of patients with newly diagnosed aggressive NHL with GI involvement defined by either tissue biopsy or imaging between 1st January 2006 and 1st January 2016. Two centers employed bowel rest as a routine measure, while two did not. The Kaplan-Meier method was used to measure time from diagnosis to perforation and death or last follow-up. Univariate and multivariate analysis of factors associated with perforation and survival was performed using Cox regression. Conclusions: Perforation occurs in 9.8% of patients with aggressive NHL and GI involvement, mostly at initial presentation, prior to chemotherapy. Small and large bowel involvement, EATL and poor ECOG are associated with increased risk of perforation. These data do not support a benefit for bowel rest and TPN in the management of unselected patients with aggressive NHL and GI involvement. Keywords: chemotherapy; extranodal lymphomas; non-Hodgkin lymphoma (NHL)
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".