Primary gastrointestinal lymphoma: a 30-year review

Area of Science:

• Oncology
• Gastroenterology
• Pathology

Background:

• Non-Hodgkin's lymphoma (NHL) can primarily involve the gastrointestinal (GI) tract.
• Accurate staging and treatment selection are crucial for patient outcomes.

Purpose of the Study:

• To review and analyze cases of primary GI non-Hodgkin's lymphoma.
• To identify prognostic factors and evaluate treatment efficacy for GI NHL.

Main Methods:

• Retrospective review of 104 primary GI NHL cases (1949-1978).
• Tumor classification using Rappaport, Lukes-Collins, and Kiel systems.
• Retrospective staging with modified Ann Arbor criteria.
• Survival analysis using life-table and Cox regression.

Main Results:

• Five-year survival was 44% overall and 53% for Stages I and II.
• Survival correlated with stage (P < 0.0001) and adjacent structure involvement (P = 0.007).
• Stage I: resection and radiation equally effective; Stage II: combined resection and radiation superior for local control.
• Recurrence rates were high (68% outside primary field, 60% outside abdomen) for Stages I and II.

Conclusions:

• Stage and adjacent structure involvement are key prognostic factors in primary GI NHL.
• Combined modality therapy may be beneficial for high-risk patients due to frequent extranodal recurrences.