Gastrointestinal Non-Hodgkin's Lymphoma

The records of 77 patients with gastrointestinal Non-Hodgkin's Lymphoma (GI-NHL) diagnosed from 1972 to 1988 were reviewed. There were 47 male and 30 female patients, median age 56 years (range 20-82 years). Twenty-four patients had stage I disease at presentation, 25 stage II, 8 stage III and 20 stage IV. The primary site was stomach for 32 patients, small bowel for 30, colon for 10, and 5 patients had multiple areas of involvement. Six patients had low grade histology, 59 intermediate grade and 12 high grade histology. Forty-two stage I and II patients underwent laparotomy; 30 had complete surgical resection, and 42 had chemotherapy. Only 21 stage III and IV patients underwent laparotomy; 15 had bowel resection and 24 had chemotherapy. Forty-one patients had evaluable disease prior to chemotherapy. Fifty-six percent achieved complete remission and 32% partial remission. At a median follow up of 46 months the median survival is 31 months, and predicted 5 and 10 year survivals are 61% and 42% respectively. Survival correlated most strongly with stage of disease at presentation (p = 0.003). Projected 10 year survival for stage I is 84%, stage II 52%, stage III 38% and no stage IV patients are alive at 10 years. Survival was significantly longer for stage I and II patients who underwent complete surgical resection (p = 0.003), but surgery did not alter survival for stage III or IV patients. Sex, the presence of B symptoms, histologic subtype or site of primary GI-NHL did not demonstrate significant correlation with prognosis.