Brief Article
Copyright ©2010 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Dec 21, 2010; 16(47): 6016-6019
Published online Dec 21, 2010. doi: 10.3748/wjg.v16.i47.6016
Diagnosis and surgical treatment of primary hepatic lymphoma
Xin-Wei Yang, Wei-Feng Tan, Wen-Long Yu, Song Shi, Yi Wang, You-Lei Zhang, Yong-Jie Zhang, Meng-Chao Wu
Xin-Wei Yang, Wei-Feng Tan, Wen-Long Yu, Song Shi, Yi Wang, You-Lei Zhang, Yong-Jie Zhang, Meng-Chao Wu, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
Author contributions: Yang XW and Tan WF performed the majority of the study and collected all the clinicopathological data; Yang XW wrote the manuscript; Yu WL, Shi S, Wang Y and Zhang YL provided analytical tools and were also involved in editing the manuscript; Zhang YJ and Wu MC designed the study; Yang XW and Tan WF contributed equally to this work.
Correspondence to: Dr. Yong-Jie Zhang, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Changhai Road 225, Shanghai 200438, China.
Telephone: +86-21-81875263 Fax: +86-21-81875263
Received: July 14, 2010
Revised: August 30, 2010
Accepted: September 7, 2010
Published online: December 21, 2010

AIM: To assess the benefits and limits of surgery for primary hepatic lymphoma (PHL), and probability of survival after postoperative chemotherapy.

METHODS: A retrospective analysis was undertaken to determine the results of surgical treatment of PHL over the past 8 years. Only nine patients underwent such treatment. The detailed data of diagnosis, treatment, and prognosis were carefully studied.

RESULTS: All patients were mistaken as having α-fetoprotein-negative hepatic cancer before pathological diagnosis. The mean delay time between initial symptoms and final diagnosis was 26.8 d (range: 14-47 d). Hepatitis B virus infection was noted in 33.3% of these patients. Most of the lesions were found to be restricted to a solitary hepatic mass. The surgical procedure performed was left hepatectomy in five cases, including left lateral segmentectomy in three. Right hepatectomy was performed in three cases and combined procedures in one. One patient died on the eighth day after surgery, secondary to hepatic insufficiency. The cumulative 6-mo, 1-year, and 2-year survival rates after hepatic surgery were, respectively, 85.7%, 71.4%, and 47.6%. One patient survived for > 5 years after surgery without any signs of recurrence until latest follow-up, who received routine postoperative chemotherapy every month for 2 years and then regular follow-up. By univariate analysis, postoperative chemotherapy was a significant prognostic factor that influenced survival (P = 0.006).

CONCLUSION: PHL is a rare entity that is often misdiagnosed, and has a potential association with chronic hepatitis B infection. The prognosis is variable, with good response to early surgery combined with postoperative chemotherapy in strictly selected patients.

Keywords: Primary hepatic lymphoma, Diagnosis, Surgery, Survival