PANCREATIC LYMPHOMA - IS IT A SURGICAL DISEASE
PANCREATIC LYMPHOMA - IS IT A SURGICAL DISEASE
复制标题
DOI：
10.1097/00006676-199409000-00019
复制
发表时间：
1994-09-01
期刊：
影响因子：
2.9
通讯作者：
STRICKLER, JG
中科院分区：
文献类型：
--
作者：
BEHRNS, KE;SARR, MG;STRICKLER, JG
原发性胰脏淋巴瘤是一种罕见的肿瘤，据报道，积极的化疗可以迅速消退。最近，手术治疗的作用已被降级为单独活检。本研究的目的是回顾我们治疗原发性胰腺淋巴瘤的经验，并确定患者接受放疗和/或化疗的结果。从1952年至1991年，107例非霍奇金淋巴瘤涉及胰腺被确定。原发性胰腺淋巴瘤12例（11%）。主要症状和体征无特异性：腹痛（83%）、体重减轻（50%）和可触及肿块（58%）。12例接受剖腹手术的患者中有6例（50%）术前诊断为胰腺癌。这些淋巴瘤很大（（$），x = 8 +/- 2 cm），由于大小、肠系膜血管侵犯、区域淋巴结转移或术中诊断为淋巴瘤而被认为不可切除。在50%的患者中仅进行活检，在25%的患者中进行了胆道分流术和/或胃肠吻合术。一个单一的切除术（胰腺切除术）进行1年后，一个完整的化疗失败。10例患者均死于进展性淋巴瘤，接受了初次术后放疗和/或化疗，随访时无患者无疾病。接受单独化疗的患者（n = 2）的平均生存期为13个月，仅接受放疗的患者（n = 5）的平均生存期为22个月，接受放疗和化疗联合治疗的患者（n = 3）的平均生存期为26个月。鉴于放射治疗和化疗的生存率低，近年来胰腺切除术的发病率和死亡率下降，应采取更积极的手术方式，包括胰腺切除或肿瘤减积。
Primary pancreatic lymphoma is a rare neoplasm that reportedly regresses promptly with aggressive chemotherapy. Recently, the role of surgical management has been relegated to biopsy alone. The aim of this study was to review our experience with primary pancreatic lymphoma and to determine the outcome of patients managed by radiation therapy and/or chemotherapy. From 1952 to 1991, 107 patients with non-Hodgkin's lymphoma involving the pancreas were identified. Twelve patients (11%) had primary pancreatic lymphoma. The presenting symptoms and signs were nonspecific: abdominal pain (83%), weight loss (50%), and a palpable mass (58%). Six of the 12 patients (50%) undergoing celiotomy had a preoperative diagnosis of pancreatic carcinoma. These lymphomas were large (($) over bar x = 8 +/- 2 cm) and deemed unresectable because of size, alleged mesenteric vessel encroachment, regional lymph node metastasis, or because of an intraoperative diagnosis of lymphoma. Biopsy alone was performed in 50% of patients and biliary bypass and/or gastroenterostomy was performed in 25% of patients. A single resection (pancreatoduodenectomy) was performed 1 year after a full course of chemotherapy had failed. Ten patients, all of whom died of progressive lymphoma, received primary postoperative radiation therapy and/or chemotherapy, and no patient was disease-free at follow-up. Mean survival was 13 months for patients who received chemotherapy alone (n = 2), 22 months for those treated with radiation therapy only(n = 5), and 26 months for those receiving combined radiation therapy and chemotherapy (n = 3). In view of the poor survival with radiation therapy and chemotherapy and the decreased morbidity and mortality of pancreatectomy in recent years, a more aggressive surgical approach including pancreatic resection or tumor debulking should be adopted.