Primary lymphoma of bone: outcome and role of surgery.

Int Orthop 2013 Dec 24;37(12):2437-42. Epub 2013 Aug 24.

Orthopaedic Oncology Department, Careggi University Hospital, Largo Palagi 1, Firenze, Italy,

Purpose: Primary bone lymphoma is a rare disease. Little is reported about surgical procedures in these patients. We evaluated a single-centre consecutive series of 21 patients for results, prognostic factors and surgical treatment.

Methods: Patient ages ranged from 19 to 82 years. The most frequently affected site was the spine (six cases), followed by the ileum, femur and mandible (three cases each). Four patients were treated with chemotherapy and 17 with chemotherapy and radiation therapy. Six patients were affected by a pathological fracture. Surgery was performed in four patients (19%), in two cases before chemotherapy, in one case during chemotherapy and in one case after chemotherapy and radiotherapy. Five patients died within the range of three to 36 months after diagnosis. Average follow-up of the remaining patients was 62.8 (19-145) months.

Results: Overall survival was 74.2% at five years. The only positive prognostic factor was complete remission after chemotherapy. A trend for better survival was present for International Prognostic Index (IPI) score (P = 0.051), under 40 years of age (P = 0.10) and abnormal lactate dehydrogenase (LDH) values (P = 0.10), but it did not reach statistical significance.

Conclusions: Surgical treatment should be aimed at restoring function and eliminating pain while minimising delays in the chemotherapy schedule. When feasible, postponing surgery until after chemotherapy is advisable.

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00264-013-2055-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3843197PMC
December 2013
19 Reads

Publication Analysis

Top Keywords

case chemotherapy
8
chemotherapy case
8
chemotherapy
8
patients
7
patients 628
4
follow-up remaining
4
diagnosis average
4
average follow-up
4
628 19-145
4
remaining patients
4
monthsresults survival
4
prognostic factor
4
factor complete
4
complete remission
4
positive prognostic
4
years positive
4
months diagnosis
4
survival 742%
4
742% years
4
19-145 monthsresults
4

References

(Supplied by CrossRef)

C Freeman et al.
Cancer 1972

RA Rudders et al.
Cancer 1978

ML Ostrowski et al.
Cancer 1986

U Gianelli et al.
Int J Surg Pathol 2002

A Alencar et al.
Leuk Lymphoma 2010

KM Ramadan et al.
Ann Oncol 2007

MU Jawad et al.
Cancer 2010

L Cai et al.
Int J Rad Oncol Biol Phys 2012

DT Marshall et al.
Clin Orthop Relat Res 2002

DR Ford et al.
Clin Oncol 2007

E Barbieri et al.
Int J Radiat Oncol Biol Phys 2004

Similar Publications