Combined surgery and chemotherapy for the treatment of primary gastrointestinal intermediate- or high-grade non-Hodgkin's lymphomas

Bellesi, G; Alterini, Renato; Messori, Andrea; Bosi, Alberto; Bernardi, Franco; Lollo, Simonetta Di; Ferrini, Pierluigi Rossi

doi:10.1038/bjc.1989.262

Cited by 47 publications

(31 citation statements)

References 41 publications

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“…A better prognosis for gastric lymphoma compared with other localizations has been described previously, 1,4,8,11,17,18,21,24,25 although several authors showed no difference in the prognosis between gastric lymphoma and intestinal lymphoma. 5,9,[13][14][15]19,20,22,23 Few publications have shown prognostic data on patients with both gastric and intestinal involvement.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, 11 English studies performed a mul- tivariate analysis for prognostic factors on patients with both gastric and intestinal lymphoma. 9,[11][12][13][14][15][16]18,19,22,24 All but one 15 demonstrated an early stage to be the most significant prognostic factor for better survival. 9,[11][12][13][14]16,18,19,22,24 The next most frequent independent prognostic factor was a younger age.…”

Section: Discussionmentioning

confidence: 99%

“…9,[11][12][13][14][15][16]18,19,22,24 All but one 15 demonstrated an early stage to be the most significant prognostic factor for better survival. 9,[11][12][13][14]16,18,19,22,24 The next most frequent independent prognostic factor was a younger age. 11,15,16,18,24 Other factors reported to have contributed to survival included female gender, 11,12,22 surgical resection, 13,14,18 low-grade histology, 12,13,24 smaller size of tumor, 15,24 and a good performance status.…”

Section: Discussionmentioning

confidence: 99%

“…9,[11][12][13][14]16,18,19,22,24 The next most frequent independent prognostic factor was a younger age. 11,15,16,18,24 Other factors reported to have contributed to survival included female gender, 11,12,22 surgical resection, 13,14,18 low-grade histology, 12,13,24 smaller size of tumor, 15,24 and a good performance status. 15,22 Anatomic site (gastric localization) was an independent prognostic factor in two studies.…”

Section: Discussionmentioning

confidence: 99%

“…The role of surgery in the treatment of gastrointestinal lymphoma has been a matter of debate. [13][14][15][16][17][18]30,31,45,46 Although past studies showed that surgical resectability was of significance, recent studies have demonstrated that nonsurgical strategies and surgery-based modalities had an equivalent efficacy. 30,31,45 Based on all these observations, and taking patients' quality of life into consideration, nonsurgical treatment is an alternative and optimal therapeutic modality for gastrointestinal lymphoma.…”

Section: Discussionmentioning

confidence: 99%

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Primary gastrointestinal lymphoma in Japan

Nakamura

Matsumoto

Iida

et al. 2003

Cancer

245

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Polymer particle agglomeration and melting causing sheet formation in fluidized bed reactors have been reported to occur during olefin polymerization. The cause of this deleterious sheet formation has not yet been established. Infrared and optical imaging were used to study the temporal temperature and size during polymerization of individual commercially active catalyst particles supported on a nylon mesh. Experiments conducted at 2100 kPa confirmed theoretical predictions that the temporal temperature rapidly attains a maximum after the start of the reaction. The magnitude of the temperature rise increases upon an increase of either reactor temperature, initial catalyst particle diameter, catalyst loading, or addition of hydrogen to the feed. The maximum transient temperature rise of single commercial catalyst particle during ethylene polymerization (7.5°C) is lower than that which can lead to local melting and polymer sheet formation. The temperature rise of particle clusters is much higher than that of individual particles, as the cluster acts as a particle with an effective diameter much larger than that of an individual particle. Thus, to circumvent polymer melting it is essential to avoid catalyst particles clustering, which may be caused by electrostatic attraction. The addition of hydrogen to the feed, often used to control polymer properties, significantly increased the initial particle temperature rise (almost double in some cases). © 2008 American Institute of Chemical Engineers AIChE J, 2008

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Primary gastrointestinal lymphoma in Japan

Nakamura

Matsumoto

Iida

et al. 2003

Cancer

245

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The role of surgery in the multimodal treatment of primary gastric non-Hodgkin's lymphomas a report of 76 cases and review of the literature

Gobbi¹,

Dionigi

Barbieri³

et al. 1990

Cancer

114

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Seventy-six patients with primary gastric non-Hodgkin's lymphomas (PGL) were diagnosed, and 75 were treated between 1975 and 1985. According to the Working Formulation 22 patients had low-grade malignant histologic subtypes, 27 intermediate-grade, and 27 high-grade. Twenty-four cases were diagnosed by endoscopic biopsies, 52 through laparotomy biopsies. Forty-five underwent subtotal or total gastric resection; seven were considered unresectable at laparotomy; 23 did not undergo surgery because of the high operative risk, mainly due to advanced age and coexisting diseases; and one died of myocardial infarction a few days after admission, before starting therapy. All patients who did not undergo laparotomy were staged with bipedal lymphangiography or abdominal ultrasonography and/or computed tomography. Stage, evaluated according to the criteria of Musshoff, was I or II1 in 16 cases, II2 in five, and IV in the remaining 55. Treatment modalities included surgery (S), chemotherapy (CT), radiotherapy (RT), and combinations thereof in the following proportions: only S in ten cases, S + CT in 32 cases, S + RT in one case, S + CT + RT in two cases, CT only in 25 cases, CT + RT in five cases. No substantial differences in response to therapy and in survival were found in relation to the different treatments. Ten-year survival was 43% in Stage I or II and 20% in Stage IV. Of the 45 resected patients, five postoperative deaths were recorded (11%). No bleeding or perforations were observed in the 30 unresected patients, and survival of such cases compared with that of the resected ones. These findings, together with data from the literature, suggest that some of the advantages claimed for surgery in PGL (debulking and abatement of the risk of perforation or hemorrhage during CT or RT) have been overestimated in relation to the intrinsic surgical risk and to the possibility of anticancer therapy. Gastric resection may still be unavoidable as a diagnostic procedure in a minority of cases and may represent the primary therapeutic procedure in clinically assessed early-stage and low-risk patients, but it cannot be considered mandatory whenever possible merely for debulking purposes or to obviate possible perforation or hemorrhage. The CT and/or RT can be effective in unresected and even bulky cases, providing minimal risk of severe hemorrhage or perforation.

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Large bowel lymphoma: An analysis of prognostic factors and therapy in 53 patients

Avilés¹,

Neri²,

Huerta‐Guzmán³

2002

Journal of Surgical Oncology

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Combined therapy appears to be an excellent therapeutic approach in this group of patients with prolonged EFS and survival, and without late toxicity. However, no prognostic factors, including IPI, could be identified to define the best therapy, probably because the number of patients, even in large series, is limited. Multicentric studies are necessary to identify prognostic factors to define therapy and outcome in this rare clinical presentation of malignant lymphoma.

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Combined surgery and chemotherapy for the treatment of primary gastrointestinal intermediate- or high-grade non-Hodgkin's lymphomas

Cited by 47 publications

References 41 publications

Primary gastrointestinal lymphoma in Japan

Primary gastrointestinal lymphoma in Japan

The role of surgery in the multimodal treatment of primary gastric non-Hodgkin's lymphomas a report of 76 cases and review of the literature

Large bowel lymphoma: An analysis of prognostic factors and therapy in 53 patients

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