Primary gastric lymphoma

Abstract

The records of 50 patients with localized primary gastric lymphoma were reviewed and clinical and prognostic factors characterized. Pathologic material was reclassified according to Rappaport's, Lukes-Collins, and Lennert's Kiel classifications. Factors with the greatest prognostic significance included initial stage as determined by surgery and pathology, absolute tumor size, degree of penetration through the stomach wall, and histologic grade of the lymphoma. After surgical resection for cure, the overall 5-year disease-free survival was 47%. For stage I disease, this was 78% vs 29% for stage II (P = 0.006). Patients with lymphomas less than 5 cm in diameter had 58% 5-year disease-free survival vs 32% for those with tumors greater than 10 cm (P = 0.06). Full-thickness penetration decreased 5-year survival from 75% to 38% (P = 0.06). Patients with histologically low-grade lymphomas had a better prognosis than those with high-grade lymphomas. The most significant correlation of histology to survival was seen with the Kiel classification with a 5-year survival of 39% for centroblastic polymorphous lymphoma vs 66% for LP immunocytoma. When lymphoma recurred it developed outside the abdomen in a majority of patients. The addition of abdominal radiation therapy to surgical resection made no significant impact on survival for either stage I or II disease.

Primary gastrointestinal non-Hodgkin's lymphoma in a population-based registry

“…T-------F-material, the Kiel classification system and the International Working Formulation were found to have the better discriminating capabilities (Dragosics et al, 1985;Dworkin et al, 1982). We found a better 1 year survival rate for nodal NHL but a higher 4-year survival rate for patients with primary gastric lymphoma (Figure la).…”

“…Grading according to the International Working Formulation appeared to be related to survival in our series ( Figures 2 and 4). In other studies only a weak (or no) association was found between prognosis and histological type as given by the Rappaport and/or Lukes-Collins classification system (Dragosics et al, 1985;Dworkin et al, 1982;Haber & Mayer, 1988;Thorling, 1984). When the different classification systems were applied to the same histological -1…”

“…In our study the modification of the Ann Arbor system by Musshoff (1977) proved to be useful as a prognostic determinant, which is in accordance with the findings of others (Dawson et al, 1961; The best treatment for primary gastric lymphoma is a matter of active debate. Many investigators (Dworkin et al, 1982;Gospodarowicz et al, 1983;Haber & Mayer, 1988;Shiu et al, 1986) claim that surgery plus postoperative radiotherapy gives the best chance of survival for those with limited disease. However, in these series, irradiation was consistently given postoperatively, so it is impossible to estimate its impact on survival.…”

“…A variety of histological classification systems led to controversial conclusions with regard to the association between histological type and prognosis (Dworkin et al, 1982;Weingrad et al, 1982). In contrast to these hospital studies we analysed the clinical and histological presentation as well as the survival data recorded in a population-based registry.…”

Primary Gastrointestinal Involvement in Non-Hodgkin’s Lymphomas

“…In the series of Dragosics et al [16], 2-year disease-free survival is 67% for stage I and 27% for stage II. Different results are reported in the series of Dworkin et al [ 18], indicating 86 and 41 % for stages I and II, respectively. According to the Musshof [39] modification of the Ann Arbor classification, stage II, has almost the same prognosis as stage I,, whereas stage II2 has a much worse prognosis.…”