Primary Non-Hodgkin's Gastric Lymphoma

ABSTRACT

PURPOSE: The aim of the study was to obtain data on the anatomic and histologic distributions, the clinical features, and the treatment results for patients with primary gastric non-Hodgkin's lymphoma. MATENRIALS AND METHODS: One hundred thirty-two patients who were treated at 8 university hospitals and 2 general hospitals between January 1991 and December 2000 were enrolled to evaluate clinico-pathologic features. RESULTS: The lower one-third of the stomach was the most frequent site (42%), and the most frequent chief complaint was epigastric pain (54%). Gastric resection was performed in 114 cases. Pathologic findings of preoperative endoscopic biopsy specimens from the 114 patients that underwent surgery were a gastric lymphoma in 94 cases (82%), a carcinoma in 15 cases (13%), an ulcer in 4 cases (4%), and a gastrointestinal stromal tumor in 1 case (1%). The stage distributions by Musshoff's criteria were 71 cases (54%) of stage IE, 36 cases (27%) of stage II1E, 8 cases (6%) of stage II2E, 2 cases (2%) of stage IIIE, and 15 cases (11%) of stage IVE. Histologic gradings by the Working Formulation in were 31 cases (23%) of low grade, 96 cases (73%) of intermediate grade, and 5 cases (4%) of high grade. Chemotherapy-related complications occurred in 25 cases (22%) while operation-related complications occurred in 6 cases (5%). Seventeen patients (13%) only underwent surgery, 19 (14%) had chemotherapy (CTx) and/or radiotherapy (RTx) only, and 96 patients (73%) received surgery and CTx and/or RTx. No substantial differences in survival were found in relation to the different histologic grades and different treatments. The five-year survival was 85% in stage I or II and 47% in stage III or IV (P=0.0000). CONCLUSION: Pathologic stage appears to be the single most important prognostic indicator. Survival differences according to treatment modalities were not statistically significant. However, the low number of patients treated with various approaches over a long period precludes a firm conclusion.