Is there a role for surgical resection in the treatment of early-stage pancreatic lymphoma?

Background: Pancreatic lymphoma is a rare neoplasm. The role of surgical re section in curing this disease is poorly defined. Study Design: From March 1983 to July 1997, eight patients with stage I or II primary pancreatic lymphoma were identified and retrospectively reviewed . All patients received chemotherapy, five patients received radiotherapy, and three patients also underwent surgical resection. A review of the publi shed pancreatic lymphoma experience in the English-language literature was also undertaken. Results: Three patients underwent pancreaticoduodenectomy with successful r esection of the lymphoma and are disease free at 64, 62, and 53 months foll owup. Five patients were treated with nonresectional therapy. Three are dis ease free at 128, 51, and 24 months. Two patients died of disease at 9 and 37 months. A review of the pancreatic lymphoma experience in the English-la nguage literature identified 122 cases of pancreatic lymphoma. Fifty-eight of these cases represented stage I or II lymphoma, which was treated withou t surgical resection with a 46% cure rate. Fifteen patients who had surgica l resection for localized disease have been reported with a 94% cure rate. Conclusions: Based on both our single institution experience and the litera ture, it is suggested that surgical resection may play a beneficial role in the treatment of localized pancreatic lymphoma, although selection factors cannot be absolutely excluded. (J Am Coll Surg 2000;190:319-330. (C) 2000 by the American College of Surgeons).