title: Primary lymphoma of bone: outcome and role of surgery.
abstract: OBJECTIVE
  Primary bone lymphoma is a rare disease. Little is reported about surgical procedures in these patients. We evaluated a single-centre consecutive series of 21 patients for results, prognostic factors and surgical treatment.
  
  
  METHODS
  Patient ages ranged from 19 to 82 years. The most frequently affected site was the spine (six cases), followed by the ileum, femur and mandible (three cases each). Four patients were treated with chemotherapy and 17 with chemotherapy and radiation therapy. Six patients were affected by a pathological fracture. Surgery was performed in four patients (19%), in two cases before chemotherapy, in one case during chemotherapy and in one case after chemotherapy and radiotherapy. Five patients died within the range of three to 36 months after diagnosis. Average follow-up of the remaining patients was 62.8 (19-145) months.
  
  
  RESULTS
  Overall survival was 74.2% at five years. The only positive prognostic factor was complete remission after chemotherapy. A trend for better survival was present for International Prognostic Index (IPI) score (P = 0.051), under 40 years of age (P = 0.10) and abnormal lactate dehydrogenase (LDH) values (P = 0.10), but it did not reach statistical significance.
  
  
  CONCLUSIONS
  Surgical treatment should be aimed at restoring function and eliminating pain while minimising delays in the chemotherapy schedule. When feasible, postponing surgery until after chemotherapy is advisable.
authors: Orthopaedic Oncology Department, Careggi University Hospital, Largo Palagi 1, Firenze, Italy, guido.scoccianti@alice.it.
authors: Guido
authors: G
authors: Scoccianti
authors: Luigi
authors: L
authors: Rigacci
authors: Benedetta
authors: B
authors: Puccini
authors: Domenico Andrea
authors: DA
authors: Campanacci
authors: Gabriele
authors: G
authors: Simontacchi
authors: Alberto
authors: A
authors: Bosi
authors: Rodolfo
authors: R
authors: Capanna
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000628:therapy*; D003131:Combined Modality Therapy; D004358:Drug Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D008223:Lymphoma / Q000378:metabolism / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D011379:Prognosis; D011859:Radiography; D011878:Radiotherapy; D015996:Survival Rate; D013977:Tibia / Q000000981:diagnostic imaging; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007770:L-Lactate Dehydrogenase
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