Weisgerber C, Bousquet R, Teillet F
Nouv Presse Med. 1975 Jun 14;4(24):1797-800.
123 laparotomies with splenectomy have been performed in 3 groups of patients. 1. 40 patients with infra-diaphragmatic relapses afer mantle field radiotherapy for supra-diaphragmatic disease. 2. 45 previously untreated patients. 3. 37 stages III B patients treated by intensive chemotherapy before splenectomy. Anatomical findings suggest that hematogenous dissemination may be responsible for spleen involvement and that spleen involvement may be suppressed by chemotherapy. In view of these data, chemotherapy in association with radiotherapy seems to be justified even in patients with apparently localised forms since the spleen may be involved in such patients at clinical presentation of the disease. From the preliminary results of studies which aim to appreciate the effectiveness of chemotherapy on splenic lesions, the need for routine laparotomy and splenectomy should be reevaluated.
对三组患者进行了123例脾切除术。1. 40例患者在接受膈上疾病的斗篷野放疗后出现膈下复发。2. 45例既往未接受治疗的患者。3. 37例III B期患者在脾切除术前接受了强化化疗。解剖学结果表明，血行播散可能是脾脏受累的原因，化疗可能会抑制脾脏受累。鉴于这些数据，即使在临床表现为明显局限性疾病的患者中，联合化疗和放疗似乎也是合理的，因为在疾病临床表现时，脾脏可能已受累。从旨在评估化疗对脾脏病变有效性的研究初步结果来看，应重新评估常规剖腹术和脾切除术的必要性。
