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Int J Gynecol Cancer. 2014 Sep;24(7):1250-5. doi: 10.1097/IGC.0000000000000201.

Institutional review of primary non-hodgkin lymphoma of the female genital tract: a 33-year experience.

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1
*Yale-New Haven Hospital; †Yale University School of Medicine, New Haven, CT; and ‡John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ.

Abstract

OBJECTIVE:

The aim of this is to provide an updated review of the literature and to report our institutional experience with this rare gynecologic malignancy.

METHODS:

The medical records of patients with diagnosis of non-Hodgkin lymphoma of the female genital tract from 1980 to 2013 at the Yale-New Haven Hospital were reviewed retrospectively. Histological classification and staging were determined by the World Health Organization and Ann Arbor systems, respectively. Kaplan-Meier was used to calculate the survival.

RESULTS:

There were 36 patients with diagnosis of non-Hodgkin lymphoma of the female genital tract and followed for a median of 61 months (0-361 months). The median age of diagnosis was 44 years (19-87 years), and 76% (n = 28) were classified as stage IV.Of these, 4 patients were asymptomatic on presentation, and 13 were identified incidentally during surgery/radiography (n = 9), on prenatal ultrasound (n = 1), and on Papanicolaou test (n = 3). The location of the disease included the ovary (n = 6), uterine corpus and cervix (n= 9), vagina (n = 1), a pelvic mass (n = 7), isolated pelvic/para-aortic lymph nodes (n = 3), and/or multiple sites (n = 9). There were 6 cases that were concomitant with other gynecologic malignancies.Diffuse large B-cell lymphoma (n= 18) was the most common histologic type. A total of 28 patients underwent surgery. Combination chemotherapy was used in 34 patients, with concomitant radiation therapy in 7 and stem cell transplantation in 3. A total of 5 patients had recurrent disease.The overall median survival from the diagnosis of lymphoma was 70 months (0.3-361 months) with a 91% 1-year survival, 86% 5-year survival, and a 79% 10-year survival.

CONCLUSIONS:

Our report is the largest published single-institution experience of this disease. It demonstrates a more favorable prognosis and proposes that with early diagnosis and appropriate therapy, radical gynecologic surgery can be avoided.

PMID:
25010039
DOI:
10.1097/IGC.0000000000000201
[Indexed for MEDLINE]
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