Gastrointestinal lymphoma and sarcoma. A case for aggressive search and destroy

The incidence of sarcomas of the gastrointestinal tract has remained the same, but gastrointestinal lymphomas are gradually contributing a larger percentage of malignant gastrointestinal neoplasms. The authors have examined their more recent experience with these relatively rare lesions. Twenty-eight patients (13 with lymphoma, 15 with sarcoma) have been treated at the Vanderbilt University and the Metropolitan Nashville General Hospital since 1976. There were eight men in the group with lymphoma and six in the group with sarcoma. The average age for patients with lymphoma was 66 years; the average age was 57 years in the patients with sarcoma. Seven patients with lymphoma and eight patients with sarcoma had been treated for 6 months to 3 years for presumed peptic ulcer disease. Eight of these 15 patients were found to have perforated tumors at the time of surgical exploration. Three patients (all in the group with sarcoma) had metastatic liver disease or peritoneal implants at the time of diagnosis. Treatment for most patients included resection of the tumor, followed by chemotherapy or radiation in cases of tumor perforation or metastatic disease. The survival rate for patients with lymphoma has averaged 5.5 years, with a 55% 5-year survival rate. Patients with cleaved cell tumors survived longer than those with other types of lymphoma. In the group with sarcoma, the survival rate has been 3.1 years on the average, with a 21% 5-year survival rate.