Treatment and prognosis of gastric lymphoma

To assess the developments in the prognosis and treatment of patients with primary gastric non-Hodgkin's lymphoma we reviewed 178 papers in English, German, and French on the subject that were listed on MEDLINE between January 1974 and April 1995. We analysed the results of 3157 patients, and during that period the overall survival increased from 37% to 87%. Overall survival by Ann Arbor stage was 57%. 998/1296 (77%) for stage IE, 231/330 (70%) for stage II1E, 107/290 (37%) for stage II2E, 53/172 (31%) for stage IIIE, and 122/451 (27%) for stage IV. Over half the publications recommended resection alone. Only 12 (15%) thought that radiotherapy or chemotherapy, alone or in combination, was adequate. The results of all treatments were similar in 1296 patients with stage IE disease. For stage IIE-IVE disease, however, 66 (82%) of authors suggested a treatment protocol that included resection, and of these 39 (49%) recommended a combination of resection, local radiotherapy, and systemic chemotherapy. The number of patients reported was too small for us to be able to give precise recommendations for treatment of gastric non-Hodgkin's lymphoma, and we have been able to give only an evaluation of current treatments.