The diagnosis and surgical treatment of primary gastric lymphoma / 中华普通外科杂志

ABSTRACT

Objeetive To probe the clinical diagnosis and surgical treatment of primary gastric lymphoma (PGL). Methods Clinical data of 23 PGL patients identified by postoperative pathology were analyzed retrospectively. Sixteen patients underwent subtotal gastrectomy,3 patients underwent total gastrectomy,2 patients underwent palliative resection and 2 patients underwent exploratory laparotomy only. Postoperatively 21 patients received adjuvant treatment(chemotherapy and/or radiotherapy).The variables analyzed were type of surgery, histological type in accordance with Kiel's classification, Involvement of lymph nodes. Ann Arbor stage classification. Results The overall 5-year survival rate of these patients Was 80%,that of low grade malignancy patients was 90%,and of high grade malignancy was 40%.Thirteen patients were classified as stage Ⅰ E and seven as stageⅡE and three as stageⅢor Ⅳ,the 5-year survival rate was 90%,67%and 0,respectively.Nineteen patients underwent radical resection with 5-year survival rate of 92.3%.No patients undergoing palliative resection have survived more than 5 years. The prognosis of PGL with low grade malignancy and that of early stages(IE and Ⅱ E)and those undergoing radical excision was better than those with high grade malignancy, that of advanced stage(Ⅲand Ⅳ),and that undergoing palliative resection. Conclusions Preoperative diagnosis relies mainly on gastroscopy with biopsy and CT scan. For patients with early stage disease,radical resection combined with adjuvant therapy is the key factor in improving the prognosis. Chemotherapy or/and radiotherapy is useful management for patients with advanced stage disease.