The Role of Surgical Intervention in the Management of Duodenal Lymphoma

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Abstract

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.

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