Clinical characteristics, treatment, and outcome of primary rectal lymphoma: a single center experience of 16 patients

Abstract

BackgroundThe rectum is a relatively uncommon site for lymphoma compared with other gastrointestinal sites; no consensus regarding management of primary rectal lymphoma (PRL) has been formed due to its limited frequency. We aimed to investigate clinical characteristics and treatment outcomes in patients with PRL in a single center patient cohort.MethodsWe retrospectively analyzed the results of 16 consecutive patients with PRL, identified and treated at the Asan Medical Center, Seoul, Korea between January 1993 and December 2014.ResultsThese 16 patients with PRL constituted 0.8% of all non-Hodgkin's lymphoma patients (N=1,984). B-cell lymphomas (N=14) made up the majority of the series, and half of these were extranodal marginal zone lymphomas (ENMZL, N=7). Ten patients received systemic chemotherapy with (N=3) or without rituximab (N=7), and 4 of these received additional local therapy. The others received radiotherapy (N=3) or endoscopic mucosal resection (N=3). Twelve patients (75%) achieved complete response (CR) after first-line treatment. Event-free survival (EFS) and overall survival (OS) in stages IE and IIE were significantly longer compared with stages IVE (P=0.001 and P=0.001, respectively). All patients with ENMZL (N=7) achieved CR during or after initial treatment.ConclusionPRL is very rare and seems to present mostly as B-cell type. Stage is the most important prognostic factor, with significantly better survival associated with localized diseases. ENMZL may be one of the most common types of PRL with favorable treatment outcomes.

Primary Rectal Non-Hodgkin’s Lymphoma Treated with Urgent Radiotherapy and Chemotherapy: A Case Report and Literature Review

“…In our case, it was an early stage (IE) disease, and we did a wide staging and management plan prior to treatment, which contributed to good outcome with a progression-free survival so far of 30 months. Thus, malignant lymphoma of the rectum should be considered a different clinicopathological entity with different behavior and clinical presentation, and treatment should be defined based on this special clinical condition [26].…”

“…In a single-center experience of 16 patients at Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, a significant difference in survival between patients with early disease, stages I through II, compared with those with late disease, stage IV, was observed. The authors assumed that stage is a good predictor of survival in primary rectal lymphoma [26].…”

Successful treatment of an enormous rectal mucosa-associated lymphoid tissue lymphoma by endoscopic full-thickness resection: A case report

“…From another perspective, colorectal MALTomas have their own features. Many clinical retrospective studies have indicated that most colorectal MALTomas could be classified as Lugano stage I and II, which are considered of lower malignancy and more slowly progressive[ 3 , 10 ]. Meanwhile, it has been indicated that the long-range outcome exhibits no significant difference between the patients who received monotherapy and those who received combined therapy (surgery or radiation)[ 2 ].…”

Ulcerative colitis and lymphoproliferative

“…Regarding treatment alternatives, there is no consensus on the best therapeutic strategy, with the options being: surgery, chemotherapy and radiotherapy, either as a single or combined treatment. 14,[32][33][34] In our patient, chemotherapy with an R-CHOP scheme was chosen, achieving criteria of complete remission after 6 cycles, without complications . In relation to the effect of chemotherapy on the evolution of IBD, different studies have shown its beneficial effect.…”