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Primary gastric lymphoma: a 15-year review
V Speranza1, D Lomanto, E Z Meli
1Cattedra di Clinica Chirurgica II, University of Rome La Sapienza, Italy.
Background/Aim:
Between 1976 and 1991, 25 patients underwent surgical therapy for primary gastric lymphoma. Clinical records were reviewed retrospectively to evaluate prognostic factors and impact of treatment on survival.
Results:
Diagnostic sensitivity of endoscopic biopsy was 68%, positively of barium contrast studies for tumor was 33%. The overall 5-year survival rate was 67.3% (51.7% "free disease"): it was for stage I E 88.9%, for stages II 1E and II 2E respectively 68.6% and 44.4% and for stage IV 33.4%. Patients with tumors smaller than 5 cm had a 5-year survival rate of 80.8% whereas for patients with larger lesions survival rate was 44% (p < 0.05). Patients with low grade malignancy tumors had a 5-year survival rate of 81.9% versus 37.5% for high grade malignancy tumors (p < 0.03). Chemotherapy as adjuvant therapy was used in 17 cases (68%). 53% of them are "free disease" at minimum 4 years from the operation.
Conclusions:
We conclude that, surgical management of primary gastric lymphoma is mandatory but a planned multimodality therapy may produce complete remission and long-term "free disease" survival rate even in patients with relapse.