Management of primary gastric lymphoma

A retrospective study of 51 patients treated for primary gastric lymphoma was made to evaluate the influence of clinicopathologic features and the method of treatment on survival. The lymphocytic type of tumor showed a higher survival rate than the histiocytic type. Tumors that involved only the gastric wall resulted in a five-year survival rate of 62%, as compared with 50% for tumors that involved also the adjacent gastric lymph nodes, and 25% for those involving the distant gastric lymph nodes. Treatment by subtotal, total, or extended forms of gastric resection without postoperative radiation gave a five-year survival rate of 33%. Resection followed by radiation yielded a higher survival rate of 67%. The best results were obtained in 13 patients who received higher doses of radiation: 11 (85%) survived five or more years. One-third of the patients developed manifestations of systemic malignant lymphoma after curative therapy. These observations suggest a planned multimodal therapeutic program for this disease.