Primary Gastrointestinal Lymphoma

Abstract

Sixteen cases of primary malignant lymphoma of the gastrointestinal tract were reviewed because of some controversy concerning its proper management. An intraabdominal disease staging system with prognostic correlation was used. Treatment employed was either (biopsy plus) irradiation alone or surgical resection of abdominal neoplasm with postoperative radiotherapy. Conventional megavoltage locoregional or subtotal/whole abdomen irradiation with an often given total dosage of 3,000–4,000 cGy up to 5.5 weeks was applied. Overall 4-year disease-free survival rate was 71%. Operative removal of neoplasm appeared important for an improved prognosis. Definitive radiotherapy alone did not have a dismal outcome.

Combined surgery and chemotherapy for the treatment of primary gastrointestinal intermediate- or high-grade non-Hodgkin's lymphomas

“…A second malignancy occurred in one case. (Gospodarowicz et al, 1983;Fleming et al, 1982;Paulson et al, 1983;Herrera et al, 1985;Dragosics et al, 1985;Ampil, 1987;Rosenfelt & Rosemberg, 1980;Economopoulos et al, 1985;Sheridan et al, 1985;Liang et al, 1987;Steward et al, 1985;Janus et al, 1984;List et al, 1988;Shepherd et al, 1988). Our study indicates that chemotherapy following surgical resection of gastrointestinal lymphomas is highly effective: we obtained 81% CRs in patients treated with partial or palliative resection, and an overall 76% 10-year causespecific survival, which are results comparable with those of other recently published reports (Paulson et al, 1983;Sheridan et al, 1985;Liang et al, 1987;Janus et al, 1984;List et al, 1988;Shepherd et al, 1988).…”

“…While several studies have emphasised the effectiveness of the complete surgical resection of localised lesions (Siegert et al, 1985;Fleming et al, 1982;Maor et al, 1984;Paulson et al, 1983), the majority of authors consider this therapeutic approach as non-curative. The clinical efficacy of adjuvant postoperative radiotherapy remains controversial (Herrmann et al, 1980;Hande et al, 1978;Gospodarowicz et al, 1983;Siegert et al, 1985;Paulson et al, 1983;Weingrad et al, 1982;Lim et al, 1977;Shimm et al, 1983;Herrera et al, 1985;Dragosics et al, 1985;Rao et al, 1984;Mittal et al, 1983;Ampil, 1987).…”

Successful Treatment of Primary Gastric Non-Hodgkin's Lymphoma with Chemotherapy and Radiotherapy.

“…Thus, many authors have suggested that gastric resection can avoid the risk of hemorrhage and perforation due to tumor necrosis (7,8,17,28,29). Our patient suffered neither perforation nor hemorrhage, probably due to non full-thickness tumor invasion and the administration of H2-blocker (2,19). Gobbi et al (19) reviewed the literature and estimated the risk of hemorrhage and/or perforation from tumor necrosis at about 4% , while the risk of death from surgery is about 7%.…”

“…"Primary" means that the initial symptoms and the predominant lesion are confined to the stomach, without any other clinically detectable extraabdominal disease foci (2). Traditionally, surgical procedures have been performed as the initial diagnostic and therapeutic step for patients with PGL.…”

“…However, due to the develop ment of endoscopic diagnostic techniques, exploratory laparotomies have recently decreased drastically (3). Surgical resection is still considered to be the primary step of treatment at many institutions (2,(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17), but resection alone cannot necessarily achieve a good pro gnosis (8,18). Moreover, total or partial gastrectomy has its own intrinsic morbidity and mortality (17,19).…”