Primary gastric lymphoma: a retrospective study

A Zeidman MD, E Ramadan MD, Z Fradin MD, Z Dreznik MD, M Mittelman MD

Rabin Medical Center, Hasharon Hospital, Petah-Tikva, Israel

AIM: The gastrointestinal tract is the predominant site of extranodal Non Hodgkin`s lymphoma, and the stomach is the most common site of occurrence for primary gastric lymphomas in the adult population. We conducted a retrospective study comparing patients who went through surgical gastrectomy alone, combined chemotherapy with surgical treatment and chemotherapy with radiotherapy, in order to evaluate the best modality. PATIENTS AND METHODS: We reviewed charts of all patients with gastric lymphoma that were hospitalized in Golda (Hasharon ) Hospital, Petah Tikva, Israel, Between 1980-2000, and were treated either surgically, combined with chemotherapy or chemoradiotherapy alone. RESULTS:44 patients were included in the study . The patients were divided into 3 groups : group A included 14 patients who went through surgery alone, group B, 13 patients with surgery and chemotherapy and group C with chemotherapy alone. 19 patients were diagnosed in the early stages (I and II), and 19 patients in later stages (III and IV). The five-year survival rate was 50%, 38%, and 27% in groups A, B, and C respectively. However, since this study followed patients until the year 2000, these numbers do not include those who survived but had not yet completed five years of follow up. When including these patients, the highest survival rate was found in group C. The relatively large number of patients in group C who were diagnosed in early stages of the disease may explain the greater survival rate in this group.. Some of the patients also received radiation therapy; however, the number of patients (7) was small and dividing them among the groups did not yield any conclusions. Conclusions: In this study if was found that chemotherapy alone is more efficacious than either surgery alone or combination surgical and chemotherapy. The survival rate was largest in those patients diagnosed in the early stages of disease (Stages I and II). Because the groups were small in size, statistical significance was not achieved. Therefore, there is a need for a large central study with many patients in order to reach this conclusion.

KEY WORDS: Non-Hodgkins Lymphoma, Chemotherapy, Surgery.

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Paper presented at the International Symposium on Predictive Oncology and Intervention Strategies; Paris, France; February 9 - 12, 2002; in the section on Novel Therapies, Part 1.