[Prognostic factors and the significance of gastrectomy in gastric lymphoma].
Fifty cases of primary gastric lymphoma treated at Tenri Hospital between 1975 and 1992 were reviewed retrospectively. Histopathologically they were classified according to the Working Formulation into three groups: low grade 3 cases, intermediate grade 42 of which 34 were diffuse large cell and high grade 5. Their clinical stages according to the Ann Arbor staging system were as follows; Stage I 15 cases, Stage II 17, Stage III 5 and Stage IV 13. Twelve variables were tested by univariate analysis for prognosis. Significant prognostic factors were clinical stage, tumor depth to the gastric wall, regional lymph node involvement, macroscopic finding of tumor shape and surgical resectability. Important variables were tested by using a multiple regression, the 5 most significant variable being curative surgical resection. The year survival after curative resection was 93.8% and 25.2% for other patients (p < 0.001). In the patients with Stage II-disease, the greater the 'N-number' of regional lymph node involvement according to the General Rules for the Gastric Cancer Study was, the lower the survival rate was due to the difficulty for curative resection (p < 0.05). The same curative resection is necessary for gastric lymphoma as for gastric cancer. In the patients with Stage III or IV disease, higher survival rate was achieved in the gastrectomy group than the others. In conclusion, an aggressive surgical intervention is warranted in the treatment of gastric lymphoma of any stage.
Ohana
M
M
Department of Gastroenterology, Tenri Hospital.
Okano
A
A
Matsushita
M
M
Konishi
Y
Y
Kusumi
F
F
Matsubayashi
Y
Y
Narusawa
H
H
Sawami
H
H
Takahashi
Y
Y
Takakuwa
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate