Artikel
Resection of central nervous system lymphoma – a paradigm shift?
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Veröffentlicht: | 13. Mai 2014 |
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Gliederung
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Objective: Primary central nervous system lymphomas (PCNSL) are regarded as non-surgically treated tumors with a poor prognosis. Usually, only stereotactic biopsy is performed to establish the diagnosis, and most patients show disease progression within half a year. A recent study (Weller et al. 2012) questioned this view, since patients who had surgical resection of PCNSL manifestations prior to adjuvant therapy had a better outcome than patients who had biopsy only.
Method: We performed a retrospective analysis of our patient database to identify patients with PCNSL who had undergone “accidental” tumor removal in our department between 2002 and 2013. All patients had PCNSL specific therapy followed surgery.
Results: 4 patients with PCNSL were treated surgically. Two patients have remission at 3 and 13 months postoperatively, while two others had disease progression at 16 and 23 months, respectively.
Conclusions: Gross total removal of PCNSL may improve outcome. We present 3 patients who had progression-free intervals of more than 12 months after surgery. While the importance of chemotherapy is beyond doubt, more data on the effect of surgery on the prognosis of patients with PCNSL are needed. However the paradigm of medical treatment only is being challenged.