Long-term outcomes of patients with primary intestinal follicular lymphoma managed with watch-and-wait strategy.

Patients with primary intestinal follicular lymphoma are often followed-up without a specific treatment, and this approach is called the "watch-and-wait approach." However, the long-term outcomes of this patient group have not been sufficiently investigated. We enrolled patients with primary intestinal follicular lymphoma who were diagnosed before 2016 and managed with the watch-and-wait approach in 20 institutions. We retrospectively investigated the overall, disease-specific, and event-free survival rates as well as the rate of spontaneous regression. Among the 248 patients with follicular lymphoma with gastrointestinal involvement, 124 had localized disease (stage I or II1). We analyzed the data of 73 patients who were managed using the watch-and-wait approach. During the mean follow-up period of 8.3 years, the follicular lymphoma had spontaneously resolved in 16.4% of the patients. The 5-year and 10-year overall survival rates were 92.9% and 87.1%, respectively. With disease progression (n = 7), initiation of therapy (n = 7), and histologic transformation to aggressive lymphoma (n = 0) defined as events, the 5-year and 10-year event-free survival rates were 91.1% and 86.9%, respectively. No patient died of progressive lymphoma. Thus, both 5-year and 10-year disease-specific survival rates were 100%. In conclusion, an indolent long-term clinical course was confirmed in the patients with primary intestinal follicular lymphoma. The watch-and-wait strategy is a reasonable approach for the initial management of these patients.

[Conduct of survey four months after the start of EMR for home visits to promote cooperation between hospitals and clinics].

Electronic medical records(EMR)for home visits were introduced in October 2013 at our institution in order to ensure smooth cooperation between the hospital and clinic by sharing the details of a patient's medical record. A system was developed for remote desktop connections to the EMR terminal server(virtual server)with the use of an SSL-VPN. Mobile terminals and mobile printers were used. Four months after the start of this system, a survey was conducted for 41 home care professionals and other staff(physicians, nurses, and office staff). Home care staff indicated that they had problems with the system, including bad connections and operating conditions, and difficulties responding to problems when they arose. Other staff indicated that they were able to acquire patient information faster than with paper-based records. Future issues include improvements to the user-friendliness of the terminals and improved responses to problems when they occur.