Matković S, Jelić S, Manojlović N, Milanović N
Institute for Oncology and Radiology of Serbia, Pasterova 14, 11000 Belgrade, Yugoslavia.
Med Sci Monit. 2000 Jan-Feb;6(1):68-74.
From 1989, at the Department of Medical Oncology of the Institute for Oncology and Radiology in Belgrade, seven patients with primary NHL of large bowel and rectum have been observed and treated, 3 males and 4 females. In 3 patients an urgent laparotomy without previous diagnostic procedures was performed, while 4 patients had laparotomy only after radiographic and endoscopic diagnosis of a tumor. Six patients had radical surgery and 1 palliative only. Five patients had lymphoma localized in cecoascedental part of colon (2 centroblastic, 1 lymphoplasmocytic, 1 Burkitt and 1 Burkitt's like), 1 patient had it in the transversal part of colon (centroblastic), and one in the rectum (diffuse centrocytic). By further investigation, in 2 cases with localization within transversal part of colon and rectum no other sites of NHL were found. They are under regular controls with 45+ and 45+ months disease free survival. Out of 5 patients with localization within cecum or ascendent part of colon, in 2 cases with Burkitt/Burkitt-like histology retroperitoneal lymphadenopathy were found, one female had NHL central propagation, and the other one lymphoma generalization. Both patients had early death from lymphoma. The remaining three patients following chemotherapy with the ProMACE regimen (as they too had a post laparotomy stage II disease) achieved a complete response lasting for 36+, 41+ and 66+ months. Since the median survival in our group of patients is at the moment 41+ months and the median has not yet been reached, our experience does not confirm literature data claiming bad prognosis of primary NHL of the colon and rectum. A long disease free survival can be obtained in these patients either with surgery only or surgery + chemotherapy, depending on disease stage and possibly initial topographic localization.
自1989年起，在贝尔格莱德肿瘤与放射研究所医学肿瘤学系，共观察并治疗了7例大肠和直肠原发性非霍奇金淋巴瘤患者，其中男性3例，女性4例。3例患者在未进行先前诊断程序的情况下接受了急诊剖腹手术，而4例患者仅在经影像学和内镜诊断出肿瘤后才进行剖腹手术。6例患者接受了根治性手术，1例仅接受了姑息性手术。5例患者的淋巴瘤位于结肠的盲升部（2例中心母细胞性、1例淋巴浆细胞性、1例伯基特淋巴瘤和1例伯基特样淋巴瘤），1例患者的淋巴瘤位于结肠横部（中心母细胞性），1例位于直肠（弥漫性中心细胞性）。通过进一步检查，在2例淋巴瘤位于结肠横部和直肠的病例中，未发现其他非霍奇金淋巴瘤部位。他们处于定期随访中，无病生存期分别为45个月以上和45个月以上。在5例淋巴瘤位于盲肠或结肠升部的患者中，2例具有伯基特/伯基特样组织学的患者发现有腹膜后淋巴结肿大，1例女性患者出现非霍奇金淋巴瘤中枢播散，另1例患者出现淋巴瘤全身播散。这两名患者均因淋巴瘤早期死亡。其余3例患者采用ProMACE方案化疗（因为他们在剖腹手术后也处于II期疾病），实现了持续36个月以上、41个月以上和66个月以上的完全缓解。由于我们这组患者目前的中位生存期为41个月以上且尚未达到中位生存期，我们的经验不支持文献中关于结肠和直肠原发性非霍奇金淋巴瘤预后不良的数据。根据疾病分期以及可能的初始部位，这些患者通过单纯手术或手术加化疗均可获得较长的无病生存期。
