title: Primary gastrointestinal non-Hodgkin's lymphoma: II. Combined surgical and conservative or conservative management only in localized gastric lymphoma--results of the prospective German Multicenter Study GIT NHL 01/92.
abstract: OBJECTIVE
  The aim of the study was to obtain data on anatomic and histologic distribution, clinical features, and treatment results of patients with primary gastrointestinal non-Hodgkin's lymphomas, particularly combined surgical and conservative treatment (CSCT) versus conservative treatment (CT) alone for primary gastric lymphoma (PGL) in localized stages.
  
  
  METHODS
  Whether the treatment included surgery was left to the discretion of each participating center. Radiotherapy (Rx) and chemotherapy were stratified according to histologic grading, stage, and the inclusion or omission of surgery as follows: patients with low-grade PGL were treated with extended-field (EF) Rx (30 Gy). In case of residual tumor after surgery or in case of CT only (in stage IIE after six cycles of cyclophosphamide, vincristine, and prednisone), an additional boost of 10 Gy was given. All patients with high-grade PGL were treated with four (stage IE) or six (stage IIE) cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone followed by EF Rx (stage IE) or involved-field (IF) Rx (stage IIE). Rx dosage corresponded to low-grade NHL.
  
  
  RESULTS
  Between October 1992 and November 1996, 106 patients had CT only. The survival rate (SR) after 5 years was 84.4% and was influenced neither by patients' characteristics nor by stage or histologic grade. Seventy-nine patients had CSCT. Their SR was 82.0%. Complete resection of the tumor (R0) was prognostic for the overall survival (P =.0165) as compared with incomplete resection.
  
  
  CONCLUSIONS
  Although the study was not randomized, a stomach-conserving approach may be favored.
authors.affiliation: Department of Medicine, and Institute for Medical Informatics and Biomathematics, Westfälische-Wilhelms-Universität, Münster, Germany. prfkoch@aol.com
authors.forename: P
authors.initials: P
authors.lastname: Koch
authors.forename: F
authors.initials: F
authors.lastname: del Valle
authors.forename: W E
authors.initials: WE
authors.lastname: Berdel
authors.forename: N A
authors.initials: NA
authors.lastname: Willich
authors.forename: B
authors.initials: B
authors.lastname: Reers
authors.forename: W
authors.initials: W
authors.lastname: Hiddemann
authors.forename: B
authors.initials: B
authors.lastname: Grothaus-Pinke
authors.forename: G
authors.initials: G
authors.lastname: Reinartz
authors.forename: J
authors.initials: J
authors.lastname: Brockmann
authors.forename: A
authors.initials: A
authors.lastname: Temmesfeld
authors.forename: R
authors.initials: R
authors.lastname: Schmitz
authors.forename: C
authors.initials: C
authors.lastname: Rübe
authors.forename: A
authors.initials: A
authors.lastname: Probst
authors.forename: G
authors.initials: G
authors.lastname: Jaenke
authors.forename: H
authors.initials: H
authors.lastname: Bodenstein
authors.forename: A
authors.initials: A
authors.lastname: Junker
authors.forename: C
authors.initials: C
authors.lastname: Pott
authors.forename: J
authors.initials: J
authors.lastname: Schultze
authors.forename: A
authors.initials: A
authors.lastname: Heinecke
authors.forename: R
authors.initials: R
authors.lastname: Parwaresch
authors.forename: M
authors.initials: M
authors.lastname: Tiemann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D011788:Quality of Life; D016019:Survival Analysis