Prognostic value of histologic and clinical factors in 56 patients with gastrointestinal lymphomas

Abstract

To investigate the prognostic value of histologic and clinical factors in lymphomas of the gastrointestinal (GI) tract, the clinicopathologic findings in 56 Japanese patients with GI lymphomas were reviewed. They included 37 patients with gastric and 19 with intestinal lymphomas. The male to female ratio was 2.7:1 in gastric and 11:1 in small intestinal lymphomas. Histologically, all but one of intestinal lymphomas were high-grade lymphomas. Gastric lymphomas comprised 47% of low-grade and 53% of high-grade tumors. Significant factors for favorable prognosis identified by Cox's multivariate analysis were female sex, the presence of reactive lymphoid hyperplasia (RLH) in the primary site, early stage of disease, gastric lymphomas, and low-grade histologic type. The important role of chronic lymphocytic infiltration for development of gastric lymphoma was suggested by the high incidence of RLH and the intermediate lymphocytic type of lymphoma.

Primary gastrointestinal lymphoma in Japan

“…Similar results were demonstrated in two previous studies. 12,19 Chronologic periods significantly influenced OS, but not EFS in our study. Weingrad et al 9 showed a similar time trend toward a better survival in the latest than the earliest period.…”

“…To our knowledge, 11 English studies performed a mul- tivariate analysis for prognostic factors on patients with both gastric and intestinal lymphoma. 9,[11][12][13][14][15][16]18,19,22,24 All but one 15 demonstrated an early stage to be the most significant prognostic factor for better survival. 9,[11][12][13][14]16,18,19,22,24 The next most frequent independent prognostic factor was a younger age.…”

“…9,[11][12][13][14][15][16]18,19,22,24 All but one 15 demonstrated an early stage to be the most significant prognostic factor for better survival. 9,[11][12][13][14]16,18,19,22,24 The next most frequent independent prognostic factor was a younger age. 11,15,16,18,24 Other factors reported to have contributed to survival included female gender, 11,12,22 surgical resection, 13,14,18 low-grade histology, 12,13,24 smaller size of tumor, 15,24 and a good performance status.…”

“…9,[11][12][13][14]16,18,19,22,24 The next most frequent independent prognostic factor was a younger age. 11,15,16,18,24 Other factors reported to have contributed to survival included female gender, 11,12,22 surgical resection, 13,14,18 low-grade histology, 12,13,24 smaller size of tumor, 15,24 and a good performance status. 15,22 Anatomic site (gastric localization) was an independent prognostic factor in two studies.…”

“…15,22 Anatomic site (gastric localization) was an independent prognostic factor in two studies. 12,18 No previous studies have shown the prognostic significance of T/B-cell immunophenotype in primary gastrointestinal lymphoma. In addition, MALT-derived lymphoma including DLBL plus MALT lymphoma was an independent prognostic factor for EFS in the current study (Table 5).…”