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Primary gastric lymphoma

M Lopez1, M Rinaldi

  • 1Istituto Regina Elena per lo Studio e la Cura dei Tumori, Roma.

Rivista Europea Per Le Scienze Mediche E Farmacologiche = European Review for Medical and Pharmacological Sciences = Revue Europeenne Pour Les Sciences Medicales Et Pharmacologiques
|September 1, 1994
PubMed
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Primary gastric lymphoma, a frequent non-Hodgkin's lymphoma (NHL), often originates from the B-cell immune system. Prognosis depends on disease extent, with gastrectomy curing one-third, and chemotherapy choices varying by case severity.

Area of Science:

  • Oncology
  • Gastroenterology
  • Hematology

Background:

  • Primary gastric lymphoma is the most common extranodal non-Hodgkin's lymphoma (NHL), representing 25% of extranodal NHL and 5% of all NHL cases.
  • It constitutes 4% of primary gastric malignancies and is frequently of the high-grade B-cell subtype (centroblastic and immunoblastic).

Purpose of the Study:

  • To review the epidemiology, prognostic factors, treatment modalities, and outcomes of primary gastric lymphoma.
  • To discuss the role of surgery, radiotherapy, and chemotherapy in managing this condition.

Main Methods:

  • Literature review of primary gastric lymphoma, focusing on epidemiology, pathology, staging, and treatment strategies.
  • Analysis of prognostic indicators, particularly the extent of disease, and therapeutic outcomes.

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Main Results:

  • Disease extent is the primary prognostic determinant in gastric lymphoma.
  • Gastrectomy alone achieves cure in approximately one-third of patients.
  • Recurrence often occurs within the gastrointestinal tract, but abdominal recurrences may involve extra-abdominal sites in 50% of cases.
  • The efficacy of adjuvant radiotherapy and chemotherapy requires further investigation.

Conclusions:

  • Treatment decisions for gastric lymphoma should be guided by disease extent and prognostic factors.
  • For advanced stages, the CHOP chemotherapy regimen is suitable for favorable prognoses, while aggressive third-generation regimens are recommended for unfavorable cases.