Is there a role for surgical resection in the treatment of early-stage pancreatic lymphoma?
BACKGROUND
Pancreatic lymphoma is a rare neoplasm. The role of surgical resection in curing this disease is poorly defined.


METHODS
From March 1983 to July 1997, eight patients with stage I or II primary pancreatic lymphoma were identified and retrospectively reviewed. All patients received chemotherapy, five patients received radiotherapy, and three patients also underwent surgical resection. A review of the published pancreatic lymphoma experience in the English-language literature was also undertaken.


RESULTS
Three patients underwent pancreaticoduodenectomy with successful resection of the lymphoma and are disease free at 64, 62, and 53 months followup. Five patients were treated with nonresectional therapy. Three are disease free at 128, 51, and 24 months. Two patients died of disease at 9 and 37 months. A review of the pancreatic lymphoma experience in the English-language literature identified 122 cases of pancreatic lymphoma. Fifty-eight of these cases represented stage I or II lymphoma, which was treated without surgical resection with a 46% cure rate. Fifteen patients who had surgical resection for localized disease have been reported with a 94% cure rate.


CONCLUSIONS
Based on both our single institution experience and the literature, it is suggested that surgical resection may play a beneficial role in the treatment of localized pancreatic lymphoma, although selection factors cannot be absolutely excluded.
Koniaris
L G
LG
Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Lillemoe
K D
KD
Yeo
C J
CJ
Abrams
R A
RA
Colemann
J
J
Nakeeb
A
A
Pitt
H
H
Cameron
J L
JL
D000328:Adult; D000368:Aged; D000465:Algorithms; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000601:surgery*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011241:Prednisone / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use
D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone