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Non-Hodgkin's lymphomas with primary localization in large bowel and rectum
S Matković1, S Jelić, N Manojlović
1Institute for Oncology and Radiology of Serbia, Pasterova 14, 11000 Belgrade, Yugoslavia.
Summary
Primary non-Hodgkin lymphoma (NHL) of the large bowel and rectum can achieve long disease-free survival with surgery and/or chemotherapy. Treatment approach depends on disease stage and location, challenging prior notions of poor prognosis.
Area of Science:
- Oncology
- Gastroenterology
- Hematology
Background:
- Primary non-Hodgkin lymphoma (NHL) of the large bowel and rectum is rare.
- Literature suggests a poor prognosis for these malignancies.
Observation:
- Seven patients with primary colorectal NHL were treated between 1989 and present.
- Diagnostic procedures varied, with some patients undergoing immediate laparotomy.
- Histological subtypes included centroblastic, lymphoplasmocytic, Burkitt, Burkitt-like, and diffuse centrocytic.
Findings:
- Five patients had localized disease in the cecum/ascending colon, one in the transverse colon, and one in the rectum.
- Two patients with rectal/transverse colon NHL achieved long-term disease-free survival with surgery alone.
- Two patients with cecum/ascending colon NHL and Burkitt/Burkitt-like histology experienced early mortality due to advanced disease.
- Three patients with stage II disease underwent chemotherapy with the ProMACE regimen, achieving complete responses lasting over 36 months.
- Median survival in the observed group was 41+ months, exceeding previously reported outcomes.
Implications:
- Primary colorectal NHL may have a better prognosis than previously suggested.
- Treatment strategies involving surgery and chemotherapy can lead to long-term survival.
- Disease stage and topographic localization appear to be critical prognostic factors.