[Primary lymphoma of the stomach. An interdisciplinary challenge].
Non-Hodgkin-lymphomas of the stomach are mostly of mucosal origin. The lymphoma derives from the acquired lymphatic tissue due to an infection with helicobacter pylori. Beside the grade of malignancy (low/high grade) the extent of the disease is the basis for therapy. It can be limited to the stomach and the lymph node compartments I and II or disseminated to both sides of the diaphragm. Therefore, pre-therapeutic diagnostic procedures have to cover all these localisations including the bone marrow. In case of a tumor limited to the stomach and of low grade malignancy an eradication therapy is the treatment of choice. More advanced tumors, but only involving stomach and lymph node compartments I and II, should be treated by subtotal or total gastrectomy plus lymphadenectomy according to the gastric cancer standards (D2). After R0-resections no adjuvant radio- or chemotherapy is necessary. R1/2 resections require radio- and/or chemotherapy which are the treatment of choice in a priori advanced stages and/or high grade lymphomas. The total 5 year survival rate is about 60-70%. Gastric lymphomas are an outstanding example of interdisciplinary disease management.
Schmidt-Matthiesen
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Klinik für Allgemein- und Gefässchirurgie, Johann Wolfgang Goethe-Universität Frankfurt/M. Schmidt-Matthiesen@em.uni-frankfurt.de
D003131:Combined Modality Therapy; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D018442:Lymphoma, B-Cell, Marginal Zone / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D010348:Patient Care Team; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate