SummaryThe results of a retrospective study of the value of reductive surgery in the treatment of abdominal Burkitt's lymphoma are reported. Nine patients had almost complete removal of the tumour, 16 had little over half of the tumour removed, and 43 underwent biopsy only. All patients subsequently received chemotherapy. There was a highly significant difference in the proportion of patients achieving a sustained durable remission (P > 0-0001) and a significant difference in survival (P > 0 05) between the group having almost complete removal and the partial resection group. Partial resection gave no advantage over no surgery. We believe that whenever possible complete removal of the abdominal tumour should be attempted regardless of the presence of extra-abdominal tumour; but unless at least 90% of the tumour can be removed there is no advantage in partial resection in terms of response to subsequent chemotherapy. In particular the removal of one of two involved ovaries can no longer be recommended. The implications of these results are related to cancer treatment strategy.

A randomized clinical trial designed to compare the effectiveness of cytoxan (CTX) alone versus a combination consisting of CTX, vincristine (Oncovin) and methotrexate (COM) in the treatment of Burkitt's lymphoma (BL) was carried out. Nineteen patients were selected at random to receive CTX alone while 21 received COM. The two treatment regimens were equally effective in inducing remissions, and complete response rates of 83.3% and 84.3% were observed for CTX- and COM-treated patients, respectively. The relapse frequencies were also equal but the pattern of relapse was clearly different. Seven out of 8 (87.5%) in the CTX group relapsed with systemic and central nervous system (CNS) tumor, while 8 out of 10 (80%) in the COM group relapsed with CNS disease only. This difference is highly significant p = 0.008. The remission durations and survival to date are the same.

Four Ugandan patients (1 women, 3 men) with generalized Kaposi's sarcoma (KS) were seen in the Uganda Cancer Institute between October 1983 and December 1984. They presented with generalized lymphadenopathy, plaques/nodules on the body, general swelling of the head, oral and visceral involvement and respiratory distress. Initial responses to adriamycin as a single or a combination chemotherapy of actinomycin D, vincristine, adriamycin and imidazole carboxamide appeared to be favourable but no sustained response was obtained. Serological tests for human T-lymphotropic virus (HTLV-II) antibodies were positive in all 4 cases. Images Figure 1 Figure 2