Jaime-Andrade Everardo, Lino-Silva Leonardo S, Salcedo-Hernández Rosa A, Zepeda-Najar César
Medicine Faculty, Universidad Autónoma de Aguascalientes, Aguascalientes, México.
Surgical Pathology, Instituto Nacional de Cancerología, Mexico City, Mexico.
J Gastrointest Oncol. 2018 Feb;9(1):90-95. doi: 10.21037/jgo.2017.10.08.
Primary colorectal lymphomas (PCLs) are very rare. We analyze a series of PCL to establish an approximate frequency of the disease and their clinico-pathological characteristics.
A retrospective cross-sectional study in a third-level hospital from 2006-2016. Clinico-pathologic features of 18 cases are presented.
PCL corresponded to 1.5% of malignant colorectal neoplasms. Ten cases presented in men, the median age was 57 years, diffuse large B-cell lymphoma (DLBCL) was the most common subtype (55.6%), 55.6% presented in cecum, 83.4% as unique polypoid tumor and the median size was 52.5 mm. The most prevalent presentation symptom was abdominal pain (61.1%). Six cases (33%) received initial surgery followed by chemotherapy, 7 cases (39%) received only chemotherapy, 2 cases received only surgery and 3 cases no-treatment. The 2-year disease specific survival was 62.7%. The only factors associated with improved survival in univariate analysis were use of surgery followed by chemotherapy (P=0.043) and HIV (P=0.043). On multivariate analysis none factor was an independent risk factor for decreased survival.
The improved overall survival rates in our series emphasize the importance of surgery followed systemic therapy in the treatment of this disease.
原发性结直肠淋巴瘤(PCL)非常罕见。我们分析了一系列PCL病例,以确定该疾病的大致发病率及其临床病理特征。
对一家三级医院2006年至2016年的病例进行回顾性横断面研究。呈现了18例患者的临床病理特征。
PCL占结直肠恶性肿瘤的1.5%。10例为男性,中位年龄为57岁,弥漫性大B细胞淋巴瘤(DLBCL)是最常见的亚型(55.6%),55.6%的病例位于盲肠,83.4%表现为孤立的息肉样肿瘤,中位大小为52.5mm。最常见的症状是腹痛(61.1%)。6例(33%)患者先接受手术,然后进行化疗,7例(39%)仅接受化疗,2例仅接受手术,3例未接受治疗。2年疾病特异性生存率为62.7%。单因素分析中,与生存率提高相关的唯一因素是先手术再化疗(P=0.043)和HIV感染(P=0.043)。多因素分析中,没有因素是生存率降低的独立危险因素。
我们系列研究中总体生存率的提高强调了手术联合全身治疗在该疾病治疗中的重要性。