title: Debulking surgery for patients with diffuse large B-cell non-Hodgkin's lymphoma.
abstract: Chemotherapy and radiotherapy have been the principal modalities of treatment for diffuse large B-cell non-Hodgkin's lymphoma (B-NHL) for over 30 years. Various treatment regimens have been designed over the years to try to increase response and cure rates. The role of surgery has been generally restricted to defined and limited situations including diagnostic tissue biopsies and treating abdominal emergencies such as organ rupture or perforation. We present two cases of refractory B-NHL, where surgery was used as a part of stepwise and multi-modal treatment with curative intent. In both cases, the treatment approach included standard dose chemotherapy, eradication of residual mass by surgery, high dose chemotherapy (HDC) with stem cell support and posttransplantant immunotherapy. Currently, 2 years after completing the therapy, both patients are well with no evidence of active disease. Based on our experience with 2 patients we believe that in specific cases of residual chemo-resistant lymphomatous mass, surgery should be considered as a part of a multimodal approach.
authors.affiliation: Department of Oncology, Soroka-University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel. RitaTo@clalit.org.il
authors.forename: Margarita
authors.initials: M
authors.lastname: Tokar
authors.forename: Ronit
authors.initials: R
authors.lastname: Yerushalmi
authors.forename: Dmitri
authors.initials: D
authors.lastname: Bobilev
authors.forename: Itai
authors.initials: I
authors.lastname: Levi
authors.forename: David
authors.initials: D
authors.lastname: Geffen
authors.forename: Ofer
authors.initials: O
authors.lastname: Shpilberg
mesh_terms: D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015898:Tomography Scanners, X-Ray Computed