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

Article Abstract:

Diagnostic capability has improved dramatically in recent years, and endoscopic biopsy has made preoperative diagnosis possible for primary gastric non-Hodgkin's lymphoma (PGL). Nevertheless, much of the insight into the treatment of this tumor was obtained in earlier years, and the optimal treatment for PGL has not yet been agreed upon. Since endoscopic biopsies raise the possibility of curative surgery with preservation of the stomach, a retrospective review of 76 patients was undertaken to determine which factors determine the best treatment of this cancer. Overall, a 43 percent survival was seen at 10 years for patients with Stage I or II cancer; for Stage IV the 10-year survival fell to 20 percent. All combinations of surgery, radiotherapy, and chemotherapy were included in the patient population, with the exception that no patient was treated with radiotherapy alone. No significant differences were found in relation to the different treatments, but five postoperative deaths were recorded from 45 surgically treated patients. This indicates that the benefits of surgery may well have been overestimated relative to the surgical risk. Although in some cases, surgical resection of the stomach may be unavoidable, it should not be regarded as mandatory in the treatment of primary gastric lymphoma. Many of the complications of gastrectomy may be avoided, while maintaining optimal chances for survival of the patient. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Stomach cancer, Gastrectomy

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Primary ileocecal lymphoma: a study of 22 patients

Article Abstract:

Non-Hodgkin's lymphoma occurring in the ileum, the distal portion of the small intestine, or the cecum, the adjacent portion of the large intestine, is relatively rare. Since ileocecal lymphoma is often grouped with other lymphomas of the digestive tract, there have been few reports about ileocecal lymphoma as a distinct entity. To evaluate the features of ileocecal lymphoma, the records of 22 patients were retrospectively evaluated. Abdominal pain, weight loss, and altered bowel habits were the most common symptoms. Half of the patients had a palpable abdominal mass on examination. Twenty-one out of 22 patients underwent surgical removal of the tumor. The stage of the tumor did not influence survival. Patients receiving chemotherapy had a median survival of 34 months as opposed to 14 months for those not receiving chemotherapy; this difference did not, however, achieve statistical significance. Failing to respond to chemotherapy was a poor prognostic sign for these patients, and achieving complete remission was a positive prognostic sign. These cases suggest that the appropriate treatment for primary lymphoma of the ileum and cecum is similar to that for gastric lymphoma. Surgery should be followed by careful staging, and the use of chemotherapy in all but early, stage IE, disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Gastrointestinal cancer, Digestive system cancer

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