Splenic marginal zone lymphoma surgery: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Splenic marginal zone lymphoma}} | {{Splenic marginal zone lymphoma}} | ||
{{CMG}}, {{AE}} {{AS}} | {{CMG}}, {{AE}}{{Affan}}, {{AS}} | ||
==Overview== | ==Overview== | ||
[[Splenectomy]] was considered to be the 1st line treatment option for [[splenic marginal zone lymphoma]] ([[SMZL]]) but recent studies have shown that [[rituximab]] is equally effective if not better treatment option in terms of overall survival. [[Splenectomy]] is still performed but mainly in patients with [[splenomegaly]] without [[lymphadenopathy]] having low surgical risk or in those who are refractory to [[rituximab]] therapy. | |||
==Surgery== | ==Surgery== | ||
* Splenectomy has been performed for the treatment of splenic marginal zone lymphoma (SMZL) over the years with a good success rate and may be delayed until the patient become symptomatic or develop cytopenia.<ref name="pmid12141954">{{cite journal |vauthors=Thieblemont C, Felman P, Berger F, Dumontet C, Arnaud P, Hequet O, Arcache J, Callet-Bauchu E, Salles G, Coiffier B |title=Treatment of splenic marginal zone B-cell lymphoma: an analysis of 81 patients |journal=Clin Lymphoma |volume=3 |issue=1 |pages=41–7 |date=June 2002 |pmid=12141954 |doi= |url=}}</ref><ref name="pmid23840125">{{cite journal |vauthors=Wu Z, Zhou J, Wang X, Li YB, Niu T, Peng B |title=Laparoscopic splenectomy for treatment of splenic marginal zone lymphoma |journal=World J. Gastroenterol. |volume=19 |issue=24 |pages=3854–60 |date=June 2013 |pmid=23840125 |pmc=3699034 |doi=10.3748/wjg.v19.i24.3854 |url=}}</ref><ref name="pmid17680218">{{cite journal |vauthors=Matutes E |title=Splenic marginal zone lymphoma with and without villous lymphocytes |journal=Curr Treat Options Oncol |volume=8 |issue=2 |pages=109–16 |date=April 2007 |pmid=17680218 |doi=10.1007/s11864-007-0026-0 |url=}}</ref> | * [[Splenectomy]] has been performed for the treatment of [[splenic marginal zone lymphoma]] ([[SMZL]]) over the years with a good success rate and may be delayed until the patient become [[symptomatic]] or develop [[cytopenia]].<ref name="pmid12141954">{{cite journal |vauthors=Thieblemont C, Felman P, Berger F, Dumontet C, Arnaud P, Hequet O, Arcache J, Callet-Bauchu E, Salles G, Coiffier B |title=Treatment of splenic marginal zone B-cell lymphoma: an analysis of 81 patients |journal=Clin Lymphoma |volume=3 |issue=1 |pages=41–7 |date=June 2002 |pmid=12141954 |doi= |url=}}</ref><ref name="pmid23840125">{{cite journal |vauthors=Wu Z, Zhou J, Wang X, Li YB, Niu T, Peng B |title=Laparoscopic splenectomy for treatment of splenic marginal zone lymphoma |journal=World J. Gastroenterol. |volume=19 |issue=24 |pages=3854–60 |date=June 2013 |pmid=23840125 |pmc=3699034 |doi=10.3748/wjg.v19.i24.3854 |url=}}</ref><ref name="pmid17680218">{{cite journal |vauthors=Matutes E |title=Splenic marginal zone lymphoma with and without villous lymphocytes |journal=Curr Treat Options Oncol |volume=8 |issue=2 |pages=109–16 |date=April 2007 |pmid=17680218 |doi=10.1007/s11864-007-0026-0 |url=}}</ref> | ||
* Response to splenectomy is partial as lymphocytosis and bone marrow infiltration persists. but it still remains a useful option for treating splenic marginal zone lymphoma in symptomatic patients.<ref name="pmid11180074">{{cite journal |vauthors=Franco V, Florena AM, Stella M, Rizzo A, Iannitto E, Quintini G, Campesi G |title=Splenectomy influences bone marrow infiltration in patients with splenic marginal zone cell lymphoma with or without villous lymphocytes |journal=Cancer |volume=91 |issue=2 |pages=294–301 |date=January 2001 |pmid=11180074 |doi= |url=}}</ref><ref name="pmid26989207">{{cite journal |vauthors=Arcaini L, Rossi D, Paulli M |title=Splenic marginal zone lymphoma: from genetics to management |journal=Blood |volume=127 |issue=17 |pages=2072–81 |date=April 2016 |pmid=26989207 |doi=10.1182/blood-2015-11-624312 |url=}}</ref><ref name="pmid25854936">{{cite journal |vauthors=Xing KH, Kahlon A, Skinnider BF, Connors JM, Gascoyne RD, Sehn LH, Savage KJ, Slack GW, Shenkier TN, Klasa R, Gerrie AS, Villa D |title=Outcomes in splenic marginal zone lymphoma: analysis of 107 patients treated in British Columbia |journal=Br. J. Haematol. |volume=169 |issue=4 |pages=520–7 |date=May 2015 |pmid=25854936 |doi=10.1111/bjh.13320 |url=}}</ref> | * Response to [[splenectomy]] is partial as [[lymphocytosis]] and [[bone marrow infiltration]] persists. but it still remains a useful option for treating [[splenic marginal zone lymphoma]] ([[SMZL]]) in [[symptomatic]] patients.<ref name="pmid11180074">{{cite journal |vauthors=Franco V, Florena AM, Stella M, Rizzo A, Iannitto E, Quintini G, Campesi G |title=Splenectomy influences bone marrow infiltration in patients with splenic marginal zone cell lymphoma with or without villous lymphocytes |journal=Cancer |volume=91 |issue=2 |pages=294–301 |date=January 2001 |pmid=11180074 |doi= |url=}}</ref><ref name="pmid26989207">{{cite journal |vauthors=Arcaini L, Rossi D, Paulli M |title=Splenic marginal zone lymphoma: from genetics to management |journal=Blood |volume=127 |issue=17 |pages=2072–81 |date=April 2016 |pmid=26989207 |doi=10.1182/blood-2015-11-624312 |url=}}</ref><ref name="pmid25854936">{{cite journal |vauthors=Xing KH, Kahlon A, Skinnider BF, Connors JM, Gascoyne RD, Sehn LH, Savage KJ, Slack GW, Shenkier TN, Klasa R, Gerrie AS, Villa D |title=Outcomes in splenic marginal zone lymphoma: analysis of 107 patients treated in British Columbia |journal=Br. J. Haematol. |volume=169 |issue=4 |pages=520–7 |date=May 2015 |pmid=25854936 |doi=10.1111/bjh.13320 |url=}}</ref> | ||
* Splenectomy has been used alone as well as in combination with chemotherapy regime for the treatment and no difference of overall survival benefit was found between the two therapeutic modalities. But they are considered superior to the use of chemotherapy alone <ref name="pmid19705496">{{cite journal |vauthors=Milosevic R, Todorovic M, Balint B, Jevtic M, Krstic M, Ristanovic E, Antonijevic N, Pavlovic M, Perunicic M, Petrovic M, Mihaljevic B |title=Splenectomy with chemotherapy vs surgery alone as initial treatment for splenic marginal zone lymphoma |journal=World J. Gastroenterol. |volume=15 |issue=32 |pages=4009–15 |date=August 2009 |pmid=19705496 |pmc=2731951 |doi= |url=}}</ref><ref name="pmid12614206">{{cite journal |vauthors=Parry-Jones N, Matutes E, Gruszka-Westwood AM, Swansbury GJ, Wotherspoon AC, Catovsky D |title=Prognostic features of splenic lymphoma with villous lymphocytes: a report on 129 patients |journal=Br. J. Haematol. |volume=120 |issue=5 |pages=759–64 |date=March 2003 |pmid=12614206 |doi= |url=}}</ref> | * [[Splenectomy]] has been used alone as well as in combination with [[chemotherapy]] regime for the treatment and no difference of overall survival benefit was found between the two therapeutic modalities. But they are considered superior to the use of [[chemotherapy]] alone <ref name="pmid19705496">{{cite journal |vauthors=Milosevic R, Todorovic M, Balint B, Jevtic M, Krstic M, Ristanovic E, Antonijevic N, Pavlovic M, Perunicic M, Petrovic M, Mihaljevic B |title=Splenectomy with chemotherapy vs surgery alone as initial treatment for splenic marginal zone lymphoma |journal=World J. Gastroenterol. |volume=15 |issue=32 |pages=4009–15 |date=August 2009 |pmid=19705496 |pmc=2731951 |doi= |url=}}</ref><ref name="pmid12614206">{{cite journal |vauthors=Parry-Jones N, Matutes E, Gruszka-Westwood AM, Swansbury GJ, Wotherspoon AC, Catovsky D |title=Prognostic features of splenic lymphoma with villous lymphocytes: a report on 129 patients |journal=Br. J. Haematol. |volume=120 |issue=5 |pages=759–64 |date=March 2003 |pmid=12614206 |doi= |url=}}</ref> | ||
* There is perioperative risk associated with splenectomy | * There is perioperative risk associated with [[splenectomy]].<ref name="pmid29043543">{{cite journal |vauthors=Kennedy ND, Lê GN, Kelly ME, Harding T, Fadalla K, Winter DC |title=Surgical management of splenic marginal zone lymphoma |journal=Ir J Med Sci |volume=187 |issue=2 |pages=343–347 |date=May 2018 |pmid=29043543 |doi=10.1007/s11845-017-1689-6 |url=}}</ref> | ||
==References== | ==References== | ||
Latest revision as of 21:56, 30 January 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Muhammad Affan M.D.[2], Sowminya Arikapudi, M.B,B.S. [3]
Overview
Splenectomy was considered to be the 1st line treatment option for splenic marginal zone lymphoma (SMZL) but recent studies have shown that rituximab is equally effective if not better treatment option in terms of overall survival. Splenectomy is still performed but mainly in patients with splenomegaly without lymphadenopathy having low surgical risk or in those who are refractory to rituximab therapy.
Surgery
- Splenectomy has been performed for the treatment of splenic marginal zone lymphoma (SMZL) over the years with a good success rate and may be delayed until the patient become symptomatic or develop cytopenia.[1][2][3]
- Response to splenectomy is partial as lymphocytosis and bone marrow infiltration persists. but it still remains a useful option for treating splenic marginal zone lymphoma (SMZL) in symptomatic patients.[4][5][6]
- Splenectomy has been used alone as well as in combination with chemotherapy regime for the treatment and no difference of overall survival benefit was found between the two therapeutic modalities. But they are considered superior to the use of chemotherapy alone [7][8]
- There is perioperative risk associated with splenectomy.[9]
References
- ↑ Thieblemont C, Felman P, Berger F, Dumontet C, Arnaud P, Hequet O, Arcache J, Callet-Bauchu E, Salles G, Coiffier B (June 2002). "Treatment of splenic marginal zone B-cell lymphoma: an analysis of 81 patients". Clin Lymphoma. 3 (1): 41–7. PMID 12141954.
- ↑ Wu Z, Zhou J, Wang X, Li YB, Niu T, Peng B (June 2013). "Laparoscopic splenectomy for treatment of splenic marginal zone lymphoma". World J. Gastroenterol. 19 (24): 3854–60. doi:10.3748/wjg.v19.i24.3854. PMC 3699034. PMID 23840125.
- ↑ Matutes E (April 2007). "Splenic marginal zone lymphoma with and without villous lymphocytes". Curr Treat Options Oncol. 8 (2): 109–16. doi:10.1007/s11864-007-0026-0. PMID 17680218.
- ↑ Franco V, Florena AM, Stella M, Rizzo A, Iannitto E, Quintini G, Campesi G (January 2001). "Splenectomy influences bone marrow infiltration in patients with splenic marginal zone cell lymphoma with or without villous lymphocytes". Cancer. 91 (2): 294–301. PMID 11180074.
- ↑ Arcaini L, Rossi D, Paulli M (April 2016). "Splenic marginal zone lymphoma: from genetics to management". Blood. 127 (17): 2072–81. doi:10.1182/blood-2015-11-624312. PMID 26989207.
- ↑ Xing KH, Kahlon A, Skinnider BF, Connors JM, Gascoyne RD, Sehn LH, Savage KJ, Slack GW, Shenkier TN, Klasa R, Gerrie AS, Villa D (May 2015). "Outcomes in splenic marginal zone lymphoma: analysis of 107 patients treated in British Columbia". Br. J. Haematol. 169 (4): 520–7. doi:10.1111/bjh.13320. PMID 25854936.
- ↑ Milosevic R, Todorovic M, Balint B, Jevtic M, Krstic M, Ristanovic E, Antonijevic N, Pavlovic M, Perunicic M, Petrovic M, Mihaljevic B (August 2009). "Splenectomy with chemotherapy vs surgery alone as initial treatment for splenic marginal zone lymphoma". World J. Gastroenterol. 15 (32): 4009–15. PMC 2731951. PMID 19705496.
- ↑ Parry-Jones N, Matutes E, Gruszka-Westwood AM, Swansbury GJ, Wotherspoon AC, Catovsky D (March 2003). "Prognostic features of splenic lymphoma with villous lymphocytes: a report on 129 patients". Br. J. Haematol. 120 (5): 759–64. PMID 12614206.
- ↑ Kennedy ND, Lê GN, Kelly ME, Harding T, Fadalla K, Winter DC (May 2018). "Surgical management of splenic marginal zone lymphoma". Ir J Med Sci. 187 (2): 343–347. doi:10.1007/s11845-017-1689-6. PMID 29043543.