Skip to main content
Annals of Surgery logoLink to Annals of Surgery
. 1996 Jan;223(1):53–62. doi: 10.1097/00000658-199601000-00008

Long-term follow-up after curative surgery for early gastric lymphoma.

D L Bartlett 1, M S Karpeh Jr 1, D A Filippa 1, M F Brennan 1
PMCID: PMC1235063  PMID: 8554419

Abstract

OBJECTIVE: This study was designed to examine the long-term survival of a homogenous group of patients with stage IE or IIE-1 gastric lymphoma after complete surgical resection. SUMMARY BACKGROUND DATA: The management of gastric lymphoma remains controversial. Enthusiasm for multimodality approaches for gastric lymphoma has lead to the current trend of using chemotherapy as primary treatment, thus avoiding gastric resection. Surgery, however, may result in improved long-term survival rates. METHODS: The records of all patients with the diagnosis of gastric lymphoma from 1980 to 1991 were reviewed retrospectively. Of 106 patients examined, 34 underwent curative resection and regional lymphadenectomy for pathologically staged IE or IIE-1 (pN1) gastric lymphoma. Fifteen patients underwent surgery alone, whereas 19 also received postoperative adjuvant therapy. RESULTS: The median follow-up time was 74 months. The 10-year actuarial disease-free survival was 91% for stage IE disease (n = 23) and 82% for stage IIE-1 disease (n = 11). There were no operative deaths and a 26% morbidity rate. No difference in survival was found for those treated with adjuvant therapy. CONCLUSIONS: The results compare favorably to those reported with the use of primary chemotherapy and radiation therapy and suggest that surgery remains the best frontline therapy for early gastric lymphoma.

Full text

PDF
57

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arranz R., Pérez G., Steegmann J. L., Cámara R., Tomás J. F., Figuera A., Vazquez L., Fernández-Rañada J. M. Unexpectedly high toxicity of MACOP-B in young patients with low grade lymphoma. Am J Hematol. 1991 Sep;38(1):75–76. doi: 10.1002/ajh.2830380115. [DOI] [PubMed] [Google Scholar]
  2. Behrns K. E., Dalton R. R., van Heerden J. A., Sarr M. G. Extended lymph node dissection for gastric cancer. Is it of value? Surg Clin North Am. 1992 Apr;72(2):433–443. doi: 10.1016/s0039-6109(16)45688-4. [DOI] [PubMed] [Google Scholar]
  3. Brooks J. J., Enterline H. T. Primary gastric lymphomas. A clinicopathologic study of 58 cases with long-term follow-up and literature review. Cancer. 1983 Feb 15;51(4):701–711. doi: 10.1002/1097-0142(19830215)51:4<701::aid-cncr2820510425>3.0.co;2-d. [DOI] [PubMed] [Google Scholar]
  4. Burgers J. M., Taal B. G., van Heerde P., Somers R., den Hartog Jager F. C., Hart A. A. Treatment results of primary stage I and II non-Hodgkin's lymphoma of the stomach. Radiother Oncol. 1988 Apr;11(4):319–326. doi: 10.1016/0167-8140(88)90203-4. [DOI] [PubMed] [Google Scholar]
  5. Chisesi T., Santini G., Capnist G., Coser P., Contu A., Porcellini A., Rizzoli V., Sertoli M., Rancan L., Salvagno L. ProMACE-MOPP vs MACOP-B in high grade non-Hodgkin's lymphomas: a randomised study in a multicenter cooperative study group (NHLCSG). Leukemia. 1991;5 (Suppl 1):107–111. [PubMed] [Google Scholar]
  6. Cogliatti S. B., Schmid U., Schumacher U., Eckert F., Hansmann M. L., Hedderich J., Takahashi H., Lennert K. Primary B-cell gastric lymphoma: a clinicopathological study of 145 patients. Gastroenterology. 1991 Nov;101(5):1159–1170. doi: 10.1016/0016-5085(91)90063-q. [DOI] [PubMed] [Google Scholar]
  7. Contreary K., Nance F. C., Becker W. F. Primary lymphoma of the gastrointestinal tract. Ann Surg. 1980 May;191(5):593–598. doi: 10.1097/00000658-198005000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Dragosics B., Bauer P., Radaszkiewicz T. Primary gastrointestinal non-Hodgkin's lymphomas. A retrospective clinicopathologic study of 150 cases. Cancer. 1985 Mar 1;55(5):1060–1073. doi: 10.1002/1097-0142(19850301)55:5<1060::aid-cncr2820550523>3.0.co;2-8. [DOI] [PubMed] [Google Scholar]
  9. Endo M., Habu H. Clinical studies of early gastric cancer. Hepatogastroenterology. 1990 Aug;37(4):408–410. [PubMed] [Google Scholar]
  10. Fleming I. D., Mitchell S., Dilawari R. A. The role of surgery in the management of gastric lymphoma. Cancer. 1982 Mar 15;49(6):1135–1141. doi: 10.1002/1097-0142(19820315)49:6<1135::aid-cncr2820490612>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
  11. Frazee R. C., Roberts J. Gastric lymphoma treatment. Medical versus surgical. Surg Clin North Am. 1992 Apr;72(2):423–431. doi: 10.1016/s0039-6109(16)45687-2. [DOI] [PubMed] [Google Scholar]
  12. Gobbi P. G., Dionigi P., Barbieri F., Corbella F., Bertoloni D., Grignani G., Jemos V., Pieresca C., Ascari E. The role of surgery in the multimodal treatment of primary gastric non-Hodgkin's lymphomas. A report of 76 cases and review of the literature. Cancer. 1990 Jun 1;65(11):2528–2536. doi: 10.1002/1097-0142(19900601)65:11<2528::aid-cncr2820651123>3.0.co;2-w. [DOI] [PubMed] [Google Scholar]
  13. Gospodarowicz M. K., Bush R. S., Brown T. C., Chua T. Curability of gastrointestinal lymphoma with combined surgery and radiation. Int J Radiat Oncol Biol Phys. 1983 Jan;9(1):3–9. doi: 10.1016/0360-3016(83)90200-6. [DOI] [PubMed] [Google Scholar]
  14. Gouzi J. L., Huguier M., Fagniez P. L., Launois B., Flamant Y., Lacaine F., Paquet J. C., Hay J. M. Total versus subtotal gastrectomy for adenocarcinoma of the gastric antrum. A French prospective controlled study. Ann Surg. 1989 Feb;209(2):162–166. doi: 10.1097/00000658-198902000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Hoerr S. O., McCormack L. J., Hertzer N. R. Prognosis in gastric lymphoma. Arch Surg. 1973 Aug;107(2):155–158. doi: 10.1001/archsurg.1973.01350200029008. [DOI] [PubMed] [Google Scholar]
  16. Jaehne J., Meyer H. J., Maschek H., Geerlings H., Burns E., Pichlmayr R. Lymphadenectomy in gastric carcinoma. A prospective and prognostic study. Arch Surg. 1992 Mar;127(3):290–294. doi: 10.1001/archsurg.1992.01420030052010. [DOI] [PubMed] [Google Scholar]
  17. Jaser N., Sivula A., Franssila K. Primary gastric non-Hodgkin's lymphoma in Finland, 1972-1977. Clinical presentation and results of treatment. Scand J Gastroenterol. 1990 Oct;25(10):1052–1059. doi: 10.3109/00365529008997634. [DOI] [PubMed] [Google Scholar]
  18. Liang R., Todd D., Chan T. K., Ng R. P., Ho F. C. Gastrointestinal lymphoma in Chinese: a retrospective analysis. Hematol Oncol. 1987 Apr-Jun;5(2):115–126. doi: 10.1002/hon.2900050206. [DOI] [PubMed] [Google Scholar]
  19. Lim F. E., Hartman A. S., Tan E. G., Cady B., Meissner W. A. Factors in the prognosis of gastric lymphoma. Cancer. 1977 Apr;39(4):1715–1720. doi: 10.1002/1097-0142(197704)39:4<1715::aid-cncr2820390449>3.0.co;2-m. [DOI] [PubMed] [Google Scholar]
  20. List A. F., Greer J. P., Cousar J. C., Stein R. S., Johnson D. H., Reynolds V. H., Greco F. A., Flexner J. M., Hande K. R. Non-Hodgkin's lymphoma of the gastrointestinal tract: an analysis of clinical and pathologic features affecting outcome. J Clin Oncol. 1988 Jul;6(7):1125–1133. doi: 10.1200/JCO.1988.6.7.1125. [DOI] [PubMed] [Google Scholar]
  21. Maor M. H., Maddux B., Osborne B. M., Fuller L. M., Sullivan J. A., Nelson R. S., Martin R. G., Libshitz H. I., Velasquez W. S., Bennett R. W. Stages IE and IIE non-Hodgkin's lymphomas of the stomach. Comparison of treatment modalities. Cancer. 1984 Dec 1;54(11):2330–2337. doi: 10.1002/1097-0142(19841201)54:11<2330::aid-cncr2820541104>3.0.co;2-v. [DOI] [PubMed] [Google Scholar]
  22. Maor M. H., Velasquez W. S., Fuller L. M., Silvermintz K. B. Stomach conservation in stages IE and IIE gastric non-Hodgkin's lymphoma. J Clin Oncol. 1990 Feb;8(2):266–271. doi: 10.1200/JCO.1990.8.2.266. [DOI] [PubMed] [Google Scholar]
  23. Mentzer S. J., Osteen R. T., Pappas T. N., Rosenthal D. S., Canellos G. P., Wilson R. E. Surgical therapy of localized abdominal non-Hodgkin's lymphomas. Surgery. 1988 Jun;103(6):609–614. [PubMed] [Google Scholar]
  24. Mittal B., Wasserman T. H., Griffith R. C. Non-Hodgkin's lymphoma of the stomach. Am J Gastroenterol. 1983 Dec;78(12):780–787. [PubMed] [Google Scholar]
  25. Musshoff K. Klinische Stadieneinteilung der Nicht-Hodgkin-Lymphome. Strahlentherapie. 1977 Apr;153(4):218–221. [PubMed] [Google Scholar]
  26. Paulson S., Sheehan R. G., Stone M. J., Frenkel E. P. Large cell lymphomas of the stomach: improved prognosis with complete resection of all intrinsic gastrointestinal disease. J Clin Oncol. 1983 Apr;1(4):263–269. doi: 10.1200/JCO.1983.1.4.263. [DOI] [PubMed] [Google Scholar]
  27. Rosen C. B., van Heerden J. A., Martin J. K., Jr, Wold L. E., Ilstrup D. M. Is an aggressive surgical approach to the patient with gastric lymphoma warranted? Ann Surg. 1987 Jun;205(6):634–640. doi: 10.1097/00000658-198706000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Rosenfelt F., Rosenberg S. A. Diffuse histiocytic lymphoma presenting with gastrointestinal tract lesions. The Stanford experience. Cancer. 1980 Apr 15;45(8):2188–2193. doi: 10.1002/1097-0142(19800415)45:8<2188::aid-cncr2820450830>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
  29. Salles G., Herbrecht R., Tilly H., Berger F., Brousse N., Gisselbrecht C., Coiffier B. Aggressive primary gastrointestinal lymphomas: review of 91 patients treated with the LNH-84 regimen. A study of the Groupe d'Etude des Lymphomes Agressifs. Am J Med. 1991 Jan;90(1):77–84. doi: 10.1016/0002-9343(91)90509-v. [DOI] [PubMed] [Google Scholar]
  30. Secco G. B., Fardelli R., Campora E., Munizzi F., Aste H., Nicolò G. Primary gastric lymphoma. J Surg Oncol. 1993 Nov;54(3):157–162. doi: 10.1002/jso.2930540306. [DOI] [PubMed] [Google Scholar]
  31. Shepherd F. A., Evans W. K., Kutas G., Yau J. C., Dang P., Scott J. G., Farquharson H. A., Francombe W. H., Bailey D., Baker M. A. Chemotherapy following surgery for stages IE and IIE non-Hodgkin's lymphoma of the gastrointestinal tract. J Clin Oncol. 1988 Feb;6(2):253–260. doi: 10.1200/JCO.1988.6.2.253. [DOI] [PubMed] [Google Scholar]
  32. Sheridan W. P., Medley G., Brodie G. N. Non-Hodgkin's lymphoma of the stomach: a prospective pilot study of surgery plus chemotherapy in early and advanced disease. J Clin Oncol. 1985 Apr;3(4):495–500. doi: 10.1200/JCO.1985.3.4.495. [DOI] [PubMed] [Google Scholar]
  33. Shimodaira M., Tsukamoto Y., Niwa Y., Goto H., Hase S., Hayakawa T., Nagasaka T. A proposed staging system for primary gastric lymphoma. Cancer. 1994 Jun 1;73(11):2709–2715. doi: 10.1002/1097-0142(19940601)73:11<2709::aid-cncr2820731110>3.0.co;2-4. [DOI] [PubMed] [Google Scholar]
  34. Shiu M. H., Karas M., Nisce L., Lee B. J., Filippa D. A., Lieberman P. H. Management of primary gastric lymphoma. Ann Surg. 1982 Feb;195(2):196–202. doi: 10.1097/00000658-198202000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Shiu M. H., Nisce L. Z., Pinna A., Straus D. J., Tome M., Filippa D. A., Lee B. J. Recent results of multimodal therapy of gastric lymphoma. Cancer. 1986 Oct 1;58(7):1389–1399. doi: 10.1002/1097-0142(19861001)58:7<1389::aid-cncr2820580702>3.0.co;2-y. [DOI] [PubMed] [Google Scholar]
  36. Smith J. W., Shiu M. H., Kelsey L., Brennan M. F. Morbidity of radical lymphadenectomy in the curative resection of gastric carcinoma. Arch Surg. 1991 Dec;126(12):1469–1473. doi: 10.1001/archsurg.1991.01410360039007. [DOI] [PubMed] [Google Scholar]
  37. Steward W. P., Harris M., Wagstaff J., Scarffe J. H., Deakin D. P., Todd I. D., Crowther D. A prospective study of the treatment of high-grade histology non-Hodgkin's lymphoma involving the gastrointestinal tract. Eur J Cancer Clin Oncol. 1985 Oct;21(10):1195–1200. doi: 10.1016/0277-5379(85)90015-x. [DOI] [PubMed] [Google Scholar]
  38. Takagi K., Nishi M., Kajitani T. Surgical treatment of gastric cancer today. Wien Klin Wochenschr. 1987 Jun 12;99(12):410–415. [PubMed] [Google Scholar]
  39. Talamonti M. S., Dawes L. G., Joehl R. J., Nahrwold D. L. Gastrointestinal lymphoma. A case for primary surgical resection. Arch Surg. 1990 Aug;125(8):972–977. doi: 10.1001/archsurg.1990.01410200030003. [DOI] [PubMed] [Google Scholar]
  40. Tanaka Y., Takao T., Watanabe H., Kido T., Ogawa N., Iwase K., Sunada S., Sando K., Kawamoto S., Koto K. Early stage gastric lymphoma: is operation essential? World J Surg. 1994 Nov-Dec;18(6):896–899. doi: 10.1007/BF00299099. [DOI] [PubMed] [Google Scholar]
  41. Topilow A. A., Guerra O. R., Tarantolo S. R., Lerner W. A., Snyder G. C. COP-BLAM multidrug infusion chemotherapies for lymphoma: results in a community hospital setting. Cancer Invest. 1993;11(4):371–378. doi: 10.3109/07357909309018868. [DOI] [PubMed] [Google Scholar]
  42. Tura S., Mandelli F., Mazza P., Pileri S., Gherlinzoni F., Bocchia M., Zinzani P. L., Fiacchini M., Martelli M., Papa G. MACOP-B vs F-MACHOP in the treatment of high-grade non-Hodgkin's lymphomas. Leukemia. 1991;5 (Suppl 1):74–78. [PubMed] [Google Scholar]
  43. Vitolo U., Bertini M., Brusamolino E., Cavallero G. B., Comotti B., Gallo E., Ghio R., Levis A., Luxi G., Meneghini V. MACOP-B treatment in diffuse large-cell lymphoma: identification of prognostic groups in an Italian multicenter study. J Clin Oncol. 1992 Feb;10(2):219–227. doi: 10.1200/JCO.1992.10.2.219. [DOI] [PubMed] [Google Scholar]
  44. Weber D. M., Dimopoulos M. A., Anandu D. P., Pugh W. C., Steinbach G. Regression of gastric lymphoma of mucosa-associated lymphoid tissue with antibiotic therapy for Helicobacter pylori. Gastroenterology. 1994 Dec;107(6):1835–1838. doi: 10.1016/0016-5085(94)90828-1. [DOI] [PubMed] [Google Scholar]
  45. Weingrad D. N., Decosse J. J., Sherlock P., Straus D., Lieberman P. H., Filippa D. A. Primary gastrointestinal lymphoma: a 30-year review. Cancer. 1982 Mar 15;49(6):1258–1265. doi: 10.1002/1097-0142(19820315)49:6<1258::aid-cncr2820490630>3.0.co;2-4. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES