Primary gastric lymphoma

Digestive Diseases and Sciences - Tập 27 - Trang 986-992 - 1982
B. Dworkin1,2,3, C. J. Lightdale1,2,3, D. N. Weingrad1,2,3, J. J. Decosse1,2,3, P. Lieberman1,2,3, D. A. Filippa1,2,3, P. Sherlock1,2,3, D. Straus1,2,3
1Gastroenterology and Lymphoma Services, Department of Medicine, Memorial Sloan-Kettering Cancer Center and Cornell University Medical College, New York
2Department of Surgery, Memorial Sloan-Kettering Cancer Center and Cornell University Medical College, New York
3Department of Pathology, Memorial Sloan-Kettering Cancer Center and Cornell University Medical College, New York

Tóm tắt

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.

Tài liệu tham khảo

Burgess HN, Dockerty MB, ReMine WH: Sarcomatous lesions of the stomach. Ann Surg 173:758–766, 1971 Novak S, Caraveo J, Trowbridge AA, Peterson RF, White RR III: Primary lymphomas of the gastrointestinal tract. South Med J 72:1154–1158, 1979 Freeman C, Berg JW, Cutler SJ: Occurrence and prognosis of extranodal lymphomas. Cancer 29:252–260, 1972 Rappaport H: Tumors of the hematopoietic system.In Atlas of Tumor Pathology, Section 3, Fasicle 8, Washington, DC, US Armed Forces Institute of Pathology, 1966 Lukes RJ, Collins RD: New approaches to the classification of the lymphomata. Br J Cancer 21(Suppl 2):1–28, 1975 Lennert K: Malignant Lymphomas: Other than Hodgkin's Disease. New York, Springer-Verlag, 1978, p. 92 Cutler SJ, Ederer F: Maximum utilization of the live table method in analyzing survival. J Chron Dis 8:699–712, 1958 Wilcoxon F: Individual comparisons by ranking methods. Biometrics 1:50–83, 1945 Petro R, Pike MC: Conservation of the approximation (O−E)2/E in the logrank test for survival data or tumor incidence data. Biometrics 29:579–584, 1973 Musshoff K: Klinische stadieneinteilung der nicht-Hodgkinlymphome. Strahlentherapie 153:218–221, 1977 Meyers MA, Katzen B, Alonson DR: Transpyloric extension to duodenal bulb in gastric lymphoma. Radiology 115:575–580, 1975 Cabre-Fiol VC, Vilardell F: Progress in the cytological diagnosis of gastric lymphoma. Cancer 41:1456–1461, 1978 Russo A, Grasso G, Sanfilippo G, Giannone G, Guerra G: Gastroscopy and directed biopsy in the diagnosis of primary gastric lymphomas. Report of 16 personal cases. Tumori 64:419–427, 1978 Posner G, Lightdale CJ, Cooper M, Sherlock P, Winawer SJ: Reappraisal of endoscopic tissue diagnosis in secondary gastric lymphoma. Gastrointest Endosc 21:123–125, 1975 Spinelli P, Gullo CL, Pizzetti P: Endoscopic diagnosis of gastric lymphomas. Endoscopy 12:211–214, 1980 Gerard-Marchant R, Hamlin I, Lennert K, Rilke R, Stansfield AG, van Unnik JAM: Histopathology of malignant lymphoma. Lancet 2:406–409, 1974 (letter) Lukes RJ, Collins RD: Lukes-Collins classification and its significance. Cancer Treat Rep 61:971–979, 1977 Lennert K, Mohri N, Stein H, Kaiserling E: The histopathology of malignant lymphoma. Br J Haematol 31(Suppl):193–203, 1975 Dorfman RF: Pathology of the non-Hodgkin's lymphomas: New classifications. Cancer Treat Rep 61:945–951, 1977 Rowenberg SA: Non-Hodgkin's lymphoma—selection of therapy on the basis of histologic type. N Engl J Med 301:924–928, 1979 Lewin KJ, Ranchod MR, Dorfman RF: Lymphomas of the gastrointestinal tract. Cancer 42:693–707, 1978 Herrmann R, Panahon AM, Barcos MP, Walsh D, Stutzman L: Gastrointestinal involvement in non-Hodgkin's lymphoma. Cancer 46:215–222, 1980 Ettinger DS, Carter D: Gastric carcinoma 16 years after gastric lymphoma irradiation. Am J Gastroenterol 68:485–488, 1977 Klarfeld J, Resnick G: Gastric remnant carcinoma. Cancer 44:1129–1133, 1979 Friedman AI: Primary lymphosarcoma of the stomach. Am J Med 26:783–796, 1959 Musshoff K, Schmidt-Vollmer H: Prognostic significance of primary site after radiotherapy in non-Hodgkin's lymphomata. Br J. Cancer 31(Suppl II):425–434, 1975 Green JA, Dawson AA, Jones PF, Brunt PW: The presentation of gastrointestinal lymphoma: Study of a population. Br J Surg 66:748–801, 1979 Lim FE, Harman AS, Tan EG, Cady B, Meissner WA: Factors in the prognosis of gastric lymphoma. Cancer 39:1715–1720, 1977 Contreary K, Nance FC, Becker WF: Primary lymphoma of the gastrointestinal tract. Ann Surg 191:593–598, 1980 Connors J, Wise L: Management of gastric lymphomas. Am J Surg 127:102–108, 1974 Bugat R, Voigt JJ, Robert A, Combes PF: Non-Hodgkin's primary lymphomas of the gastrointestinal tract. Front Gastrointest Res 4:192–197, 1979 Loehr WJ, Mujahed Z, Zahn FD, Gray GF, Thorbjarnarson B: Primary lymphoma of the gastrointestinal tract. Ann Surg 170:232–238, 1969 Kahn LB, Selzer G, Kaschula ROC: Primary gastrointestinal lymphoma. Am J Dig Dis 17:219–232, 1972 Remine WH: Gastric sarcomas. Am J Surg 120:320–323, 1970 Blackledge G, Bush H, Dodge OG, Crother D: A study of gastrointestinal lymphoma. Clin Oncol 5:209–219, 1979 Welborn JK, Ponka JL, Rebuck JW: Lymphoma of the stomach. Arch Surg 90:480–487, 1965 Cathcart RS, Sutton JP, Gregorie HB: Sarcomas of the stomach. Ann Surg 173:398–402, 1971 Sherlock P, Winawer SJ, Goldstein MJ, Bragg DG: Malignant lymphoma of the gastrointestinal tract. Prog Gastroenterol 2:367–391, 1970 Eckhart S: Advances in the therapy of non-Hodgkin's lymphoma. Recent Results Cancer Res 69:63–75, 1979 Bonnadonna G, Tattuada A, Monfardini S, Milani F, Banfi A: Combined radiotherapy—chemotherapy in localized non-Hodgkin's lymphomas: 5-year results of a randomized study.In Adjuvant Therapy of Cancer II. SE Jones, SE Salmon (eds). New York, Grune and Stratton, 1979, pp 145–153
Thông tin
Thông tin xuất bản

Digestive Diseases and Sciences

Tập 27

986-992

Thông tin tác giả