Conservative management in primary genital lymphomas: The role of chemotherapy

Mauro Signorelli, Andrea Maneo, Sabrina Cammarota, Giuseppe Isimbaldi, Rita Garcia Parra, Patrizia Perego, Enrico Maria Pogliani, Costantino Mangioni

Research output: Contribution to journalArticle

Abstract

Background.: The female genital lymphomas are an extremely rare disease accounting for less than 0.5% of gynecological cancers and for 1.5% of all NHL. Because of their low incidence there is no widely accepted consensus on its treatment. Literature data support a radiotherapy-based treatment in case of primary genital lymphomas stages I-II. The role of chemotherapy as neoadjuvant or exclusive treatment is still to be defined. Methods.: From 1984 to 2003, the treatments in our institution of 19 patients with genital lymphoma were reviewed. Nine women presented with cervical, 3 with vaginal, 1 with cervical-vaginal, 2 with vulvar and 4 with ovarian lymphoma. Seven were staged IE, nine IIE, one IIIE and two IVE. As a whole, chemotherapy was used in 18/19 cases: chemotherapy was proposed as first line treatment in 12 cases, while surgery in 7 (followed by chemotherapy in 6 cases). Results.: Primary chemotherapy alone obtained a complete response (CR) in 9/12 patients; pathological complete response (pCR) was confirmed in 3 operated patients out of 9. Partial response (PR) was observed in 3, requiring radiotherapy. Chemotherapy obtained CR after incomplete surgical debulking in 3 out of 4 cases. Two patients relapsed in the group treated with chemotherapy alone. Both have been salvaged by further chemotherapy. Only one patient deceased due to her tumor after surgery and chemotherapy. Conclusion.: The use of exclusive chemotherapy obtained promising results not only as regards survival rates but also for reducing the need of radiotherapy. A conservative management based on exclusive chemotherapy in primary genital lymphoma stages I-II may be attempted in selected patients desiring pregnancy.

Original languageEnglish
Pages (from-to)416-421
Number of pages6
JournalGynecologic Oncology
Volume104
Issue number2
DOIs
Publication statusPublished - Feb 2007

Keywords

  • Chemotherapy
  • Conservative management
  • Primary genital lymphomas

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology

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    Signorelli, M., Maneo, A., Cammarota, S., Isimbaldi, G., Garcia Parra, R., Perego, P., Maria Pogliani, E., & Mangioni, C. (2007). Conservative management in primary genital lymphomas: The role of chemotherapy. Gynecologic Oncology, 104(2), 416-421. https://doi.org/10.1016/j.ygyno.2006.08.024