Prognostic factors in primary gastrointestinal non-Hodgkin's lymphoma: a multivariate analysis of 76 cases.
OBJECTIVE
To present our experience with the treatment of primary gastrointestinal (GI) non-Hodgkin's lymphoma, evaluate prognostic factors, and give our recommendations for treatment.


METHODS
Retrospective study.


METHODS
Teaching hospital, Spain.


METHODS
76 patients (47 men and 29 women, mean age 51 years) treated over the 15 years 1980-1994.


METHODS
52 patients had radical resections, 19 palliative resections, and 5 biopsy alone. 42 (55%) also had adjuvant chemotherapy and 20 (26%) radiotherapy.


RESULTS
Patients with primary intestinal lymphoma were slightly but not significantly younger than those with gastric lymphoma (43 compared with 56 years). 43 Patients (57%) had tumours in the stomach, 26 (34%) in the small bowel, and 7 (9%) in the colon. At presentation 34 had stage I disease, 25 stage IIE1 disease, and the remaining 17 stage IIE2; 14 were classified as low grade, 41 as intermediate, and 21 as high grade. 60 (79%) had a B-cell phenotype. Overall 5-year survival was 53%. Of the 11 variables tested by univariate analysis for their prognostic effect only abdominal mass (p < 0.001), clinical stage (p < 0.001), type of operation (p < 0.001), tumour size (p < 0.05), and histological grade (p < 0.05) achieved significance, but when Cox's multivariate analysis was applied only clinical stage was significant (p < 0.01).


CONCLUSIONS
Operation is the treatment of choice, but chemotherapy and radiotherapy may have a role though as yet there are no standard guidelines for their use.
Department of General Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain.
F
F
Sanchez-Bueno
J A
JA
Garcia-Marcilla
J D
JD
Alonso
J
J
Acosta
L
L
Carrasco
A
A
Piñero
P
P
Parrilla
D017024:Chemotherapy, Adjuvant; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000453:epidemiology* / Q000601:surgery / Q000628:therapy; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology* / Q000601:surgery / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010166:Palliative Care; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate