The role of surgical intervention in the management of duodenal lymphoma.
OBJECTIVE
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.
Department of Surgery, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta T2N 4N2, Canada.
Kourosh
K
Sarkhosh
Oliver F
OF
Bathe
Douglas A
DA
Stewart
Lloyd A
LA
Mack
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D004379:Duodenal Neoplasms / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016393:Lymphoma, B-Cell / Q000188:drug therapy / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D016019:Survival Analysis
D000970:Antineoplastic Agents