Clinical features and outcome of primary pancreatic lymphoma Journal Article

Authors: Sadot, E.; Yahalom, J.; Do, R. K. G.; Teruya-Feldstein, J.; Allen, P. J.; Gönen, M.; D'Angelica, M. I.; Kingham, T. P.; Jarnagin, W. R.; DeMatteo, R. P.
Article Title: Clinical features and outcome of primary pancreatic lymphoma
Abstract: Introduction: Primary pancreatic lymphoma (PPL) is a rare tumor that is often misdiagnosed. Clinicopathologic features, optimal therapy, and outcomes are not well defined. We reviewed our institutional experience with PPL. Methods: Search of our institutional database identified that between 1987–2012, 21,760 patients with lymphoma and 11,286 patients with a primary pancreatic tumor were evaluated. There were 44 patients with pathologically confirmed PPL. Clinical data were obtained by chart review and survival distributions were estimated using the Kaplan–Meier method and compared using the log-rank test. Results: At baseline, LDH was elevated in 55 % of the patients, CA 19-9 in 25 %, and CEA in 20 %. Imaging characteristics included large, unresectable tumors (67 %), and lymphadenopathy inferior to the renal vein (50 %). Twenty-three patients underwent surgery for resection (5), diagnosis (13), or palliation (5). Chemotherapy alone achieved a 75 % complete response rate. Eight patients experienced relapse, 88 % of which occurred at distant sites. Median overall survival was 6.1 years and 10-year disease-specific survival (DSS) was 69 %. Patients with a low risk International Prognostic Index (IPI) and those with a follicular histologic subtype demonstrated 5-year DSS of 100 %. Conclusions: Chemotherapy for PPL results in a high complete response rate and long DSS, which is similar to nodal non-Hodgkin’s lymphoma (NHL). A favorable outcome is expected for IPI low risk patients and follicular histologic subtype. Systemic therapy should generally be the initial therapy when the diagnosis is known. Prolonged follow up is recommended to detect relapses. Surgery alone should be reserved for non-curative intent (i.e. diagnostic or palliative). © 2014, Society of Surgical Oncology.
Journal Title: Annals of Surgical Oncology
Volume: 22
Issue: 4
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2015-04-01
Start Page: 1176
End Page: 1184
Language: English
DOI: 10.1245/s10434-014-4176-6
PROVIDER: scopus
PUBMED: 25341750
PMCID: PMC4574284
Notes: Export Date: 4 May 2015 -- Source: Scopus
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MSK Authors
  1. Joachim Yahalom
    407 Yahalom
  2. Ronald P DeMatteo
    602 DeMatteo
  3. Julie T Feldstein
    288 Feldstein
  4. Mithat Gonen
    716 Gonen
  5. Peter Allen
    442 Allen
  6. William R Jarnagin
    596 Jarnagin
  7. Kinh Gian Do
    116 Do
  8. T Peter Kingham
    293 Kingham
  9. Eran Sadot
    36 Sadot