Treatment Response in Patients with Primary Colonic Lymphomas: Experience in a Single Institute

原發性結腸惡性淋巴癌單一醫學中心之治療經驗

吳岳嶸(Yueh-Jung Wu) ； 盧建璋(Chien-Chang Lu) ； 林尚潁(Shung-Eing Lin) ； 張家駱(Chia-Lo Chang) ； 胡萬祥(Wang-Hseng Hu) ； 李克釗(Ko-Chao Lee) ； 陳鴻華(Hong-Hwa Chen)

《中華民國大腸直腸外科醫學會雜誌》 23卷2期 (2012/06) Pp. 39-47

https://doi.org/10.6312/SCRSTW.2012.23(2).10018

摘要

Purpose. To review the clinical characteristics, treatments and prognosis of the rare malignancy, primary colonic lymphoma at a single-institute in southern Taiwan.Methods. More than 8953 colon or rectal cancers were reviewed at Chang Gung Medical Center in Kaohsiung from 1989 to 2009, with only 21 cases diagnosed as primary colonic lymphoma. The records of those patients were retrospectively analyzed for age, gender, clinical presentation, location and stage of tumor, operation, adjunctive therapy, survival time and clinical outcome. Cox regression and Kaplan-Meier methods were applied to estimate the prognostic factors for the patient survival time.Results. Twenty-one patients with primary colonic lymphoma were identified which constituted 0.2% of all reported cases of colorectal cancer in our institute. The mean age at diagnosis was 53.9 years (range, 15-86 years), with a male to female ratio of 16:5. The most common tumor site was the cecum, followed by the ascending colon. All patients had B-cell lymphoma. Seventeen patients had undergone an operation. The chemotherapy was applied to 12 patients out of 21. The overall five-year survival rate was 42.9% (N = 21, median survival time: 12.7 months). Prognostic factors including disease stage, operation method (curative vs. palliative), operation timing (elective vs. emergency) and chemotherapy showed a significant influence on the survival time (all p ＜ 0.05).Conclusion. The choice of treatment for primary colorectal lymphoma is multimodality, adequate curative surgical resection in selected patients followed by adjuvant chemotherapy seems to result in a favorable outcome.

關鍵字

惡性淋巴癌 ； 輔助性化學治療 ； 結腸與直腸 ； B細胞

並列摘要

Purpose. To review the clinical characteristics, treatments and prognosis of the rare malignancy, primary colonic lymphoma at a single-institute in southern Taiwan.Methods. More than 8953 colon or rectal cancers were reviewed at Chang Gung Medical Center in Kaohsiung from 1989 to 2009, with only 21 cases diagnosed as primary colonic lymphoma. The records of those patients were retrospectively analyzed for age, gender, clinical presentation, location and stage of tumor, operation, adjunctive therapy, survival time and clinical outcome. Cox regression and Kaplan-Meier methods were applied to estimate the prognostic factors for the patient survival time.Results. Twenty-one patients with primary colonic lymphoma were identified which constituted 0.2% of all reported cases of colorectal cancer in our institute. The mean age at diagnosis was 53.9 years (range, 15-86 years), with a male to female ratio of 16:5. The most common tumor site was the cecum, followed by the ascending colon. All patients had B-cell lymphoma. Seventeen patients had undergone an operation. The chemotherapy was applied to 12 patients out of 21. The overall five-year survival rate was 42.9% (N = 21, median survival time: 12.7 months). Prognostic factors including disease stage, operation method (curative vs. palliative), operation timing (elective vs. emergency) and chemotherapy showed a significant influence on the survival time (all p ＜ 0.05).Conclusion. The choice of treatment for primary colorectal lymphoma is multimodality, adequate curative surgical resection in selected patients followed by adjuvant chemotherapy seems to result in a favorable outcome.

並列關鍵字

Lymphoma ； Colorectal ； Adjuvant chemotherapy ； B-cell