title: Advantage of surgery and adjuvant chemotherapy in the treatment of primary gastrointestinal lymphoma.
abstract: BACKGROUND
  Surgery has been the mainstay of treatment for gastrointestinal (GI) lymphoma. The role of adjuvant chemotherapy to surgery has not been clearly elucidated.
  
  
  METHODS
  The review covered 100 patients who were diagnosed with primary GI lymphoma and treated from 1980 to 1993 at Providence Hospital (Southfield, MI), and Hartford and St. Francis Hospitals (Hartford, CT) with a median follow-up of 5 years. Forty-two patients were treated with surgery alone; 31 patients with surgery and adjuvant chemotherapy; 23 patients with primary chemotherapy, and 4 patients received no treatment.
  
  
  RESULTS
  The 5-year actuarial survival based on the above treatments calculated by life-table analysis were 57%, 76%, 58%, and 0%, respectively. This series showed that surgery with adjuvant chemotherapy significantly improved the 5-year actuarial survival of patients with primary GI Lymphoma and that primary chemotherapy showed comparable survival to surgery alone. There was no difference in prognosis when comparing patients with different stage, grade, or location of disease in the GI tract.
  
  
  CONCLUSIONS
  We recommend surgery when feasible with adjuvant chemotherapy as the mainstay of treatment for primary GI lymphoma. However, if a patient presents with comorbid factors, primary chemotherapy offers an effective alternative.
authors.affiliation: Department of General Surgery, Providence Hospital, Southfield, Michigan, USA.
authors.forename: K M
authors.initials: KM
authors.lastname: Lin
authors.forename: D G
authors.initials: DG
authors.lastname: Penney
authors.forename: A
authors.initials: A
authors.lastname: Mahmoud
authors.forename: W
authors.initials: W
authors.lastname: Chae
authors.forename: R B
authors.initials: RB
authors.lastname: Kolachalam
authors.forename: S C
authors.initials: SC
authors.lastname: Young
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis