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The role of surgical intervention in the management of duodenal lymphoma
Author(s) -
Sarkhosh Kourosh,
Bathe Oliver F.,
Stewart Douglas A.,
Mack Lloyd A.
Publication year - 2009
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21269
Subject(s) - medicine , perforation , chemotherapy , lymphoma , surgery , stage (stratigraphy) , retrospective cohort study , demographics , cancer , paleontology , materials science , demography , sociology , biology , punching , metallurgy
Background and Objectives The role of surgical management in duodenal lymphoma is controversial due to the rarity of this tumor subtype. A retrospective review of a provincial cancer registry was performed to assess the rationale for surgical management in duodenal lymphoma. Methods Patient demographics, presentations, pathologies, surgical interventions, treatment, and associated disease‐specific survival were assessed and descriptively presented. Results From 1985 to 2005, 23 patients (mean age 58 years [22–82]) were diagnosed. The most common histology was large B‐cell lymphoma (74%). A significant proportion presented in a complicated fashion: obstruction (30%), perforation (17%), and hemorrhage (4%). Eight patients (35%) were treated with surgery alone, eight (35%) with surgery and chemotherapy, five (22%) with chemotherapy alone, and two (9%) with supportive care. Of those treated with surgery, indications were mostly emergent conditions including obstruction (58%), perforation (33%), and hemorrhage (8%). Overall median follow‐up was 14 months (1–168 months) and overall median survival was 12 months (1–168 months). There were no significant differences in survival by histology, stage, or treatment type. Conclusions Chemotherapy continues to represent the therapeutic mainstay for GI lymphomas. However, in duodenal lymphoma, a high proportion of patients require surgery mainly because of complicated presentations. J. Surg. Oncol. 2009;99:428–432. © 2009 Wiley‐Liss, Inc.