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[Gastric lymphomas: surgical indications].
G Benfatto1, G Catania, S D'Antoni
1Università degli Studi di Catania, Dipartimento di Chirurgia.
Il Giornale Di Chirurgia
|March 17, 2004
Summary
Surgery is a highly effective treatment for primary gastric lymphoma (PGL), offering high recovery rates and long-term survival, especially when performed in early disease stages. Helicobacter pylori eradication is a primary option for low-grade MALT PGL.
Area of Science:
- Gastroenterology
- Oncology
- Surgical Oncology
Context:
- Primary gastric lymphoma (PGL) comprises B-cell non-Hodgkin lymphomas localized exclusively in the stomach.
- Understanding the optimal treatment strategy for PGL is crucial for patient outcomes.
Purpose:
- To determine the role of surgical intervention in the management of primary gastric lymphoma.
- To evaluate surgical outcomes in PGL based on a clinical series and literature review.
Summary:
- The study analyzed 41 PGL patients over 10 years, with 35 undergoing surgery (18 with chemotherapy) and 6 treated with Helicobacter pylori (H.P.) eradication.
- H.P. eradication achieved 97% eradication rates and 70% MALT lymphoma regression, serving as a first-line therapy for early-stage, low-grade MALT PGL.
- Surgery is recommended for partial regression or progression, offering high definitive recovery rates (90% survival >10 years) in early stages. Total gastrectomy with lymphadenectomy and potential splenectomy is suggested as the elective surgical approach.
Impact:
- Highlights surgery as a key treatment modality for PGL, particularly in early stages, leading to high long-term survival.
- Provides evidence supporting H.P. eradication as an initial treatment for specific PGL subtypes.
- Informs clinical decision-making regarding the surgical management of primary gastric lymphoma.