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Diagnostic and therapeutic splenectomy for splenic lymphomas: analysis of the National Cancer Data Base
| Content Provider | Scilit |
|---|---|
| Author | Fallah, Jaleh Olszewski, Adam J. |
| Copyright Year | 2019 |
| Description | Objectives: To examine the use of splenectomy, chemotherapy, and subsequent overall survival (OS) in contemporary patients with splenic lymphomas. Methods: We analyzed records of 6450 patients with various splenic lymphomas recorded in the National Cancer Data Base (2004–2013). Survival was compared using Mantel-Byer test to account for guarantee-time bias, stratified by age, sex, comorbidities, and lymphoma stage. Results: Splenectomy rate was overall 58%, and varied from 49% in splenic marginal zone (SMZL) to 77% in follicular lymphoma (FL). It significantly decreased across all histologies over time (overall from 69% in 2004, to 44% in 2013). Thirty-day mortality after splenectomy was 4%. Chemotherapy use varied from 40% in FL to 76% in diffuse large B-cell lymphoma (DLBCL), but increased significantly only for SMZL and T-cell lymphomas over time. Overall, 57% of splenectomies were performed as diagnostic procedures, which was significantly less common in academic hospitals (p < 0.0001). Following a diagnostic splenectomy, chemotherapy was not administered to 29% of patients with DLBCL, 49% with mantle cell, and 42% with T-cell lymphomas. Median OS ranged from 12.4 years for FL to 1.0 year for T-cell lymphomas. We found no association between performance of splenectomy and OS across all histologies. Patients with DLBCL who did not receive chemotherapy after a diagnostic splenectomy had significantly worse OS (p = 0.001). The association between post-splenectomy chemotherapy and OS was not observed in FL or SMZL. Conclusion: many splenic lymphomas may be treated without surgery, but a high proportion of diagnostic splenectomies indicates an ongoing need for less invasive diagnostic modalities. |
| Related Links | https://www.tandfonline.com/doi/pdf/10.1080/16078454.2019.1591570?needAccess=true https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6425967/pdf |
| Ending Page | 386 |
| Page Count | 9 |
| Starting Page | 378 |
| ISSN | 10245332 |
| e-ISSN | 16078454 |
| DOI | 10.1080/16078454.2019.1591570 |
| Journal | Hematology |
| Issue Number | 1 |
| Volume Number | 24 |
| Language | English |
| Publisher | Informa UK Limited |
| Publisher Date | 2019-01-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Hematology Surgery Epidemiology Splenectomy Splenic Marginal Zone Lymphoma Follicular Lymphoma Mantle Cell Lymphoma Diffuse Large B-cell Lymphoma |
| Content Type | Text |
| Resource Type | Article |
| Subject | Hematology |
