title: Primary early-stage intestinal and colonic non-Hodgkin's lymphoma: clinical features, management, and outcome of 37 patients.
abstract: OBJECTIVE
  To analyze the clinical features, management, and outcome of treatment of patients with primary intestinal and colonic non-Hodgkin's lymphoma (PICL).
  
  
  METHODS
  A retrospective study was performed in 37 patients with early-stage PICL who were treated in our hospital from 1958 to 1998. Their clinical features, management, and outcome were assessed. Prognostic factors for survival were analyzed by univariate analysis using the Kaplan-Meier product-limit method and log-rank test.
  
  
  RESULTS
  Twenty-five patients presented with Ann Arbor stage I PICL and 12 with Ann Arbor stage II PICL. Thirty-five patients underwent surgery (including 31 with complete resection), 22 received postoperative chemotherapy or radiotherapy or both. Two patients with rectal tumors underwent biopsy and chemotherapy with or without radiotherapy. The 5- and 10-year overall survival (OS) rates were 51.9% and 44.5%. The corresponding disease-free survival (DFS) rates were 42.4% and 37.7%. In univariate analysis, multiple-modality treatment was associated with a better DFS rate compared to single treatment (P = 0.001). While age, tumor size, tumor site, stage, histology, or extent of surgery were not associated with OS and DFS, use of adjuvant chemotherapy significantly improved DFS (P = 0.031) for the 31 patients who underwent complete resection. Additional radiotherapy combined with chemo-therapy led to a longer survival than chemotherapy alone in six patients with gross residual disease after surgery or biopsy.
  
  
  CONCLUSIONS
  Combined surgery and chemotherapy is recommended for treatment of patients with PICL. Additional radiotherapy is needed to improve the outcome of patients who have gross residual disease after surgery.
authors.affiliation: Department of Radiation Oncology, Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100021, China. slwang@mdanderson.org
authors.forename: Shu-Lian
authors.initials: SL
authors.lastname: Wang
authors.forename: Zhong-Xing
authors.initials: ZX
authors.lastname: Liao
authors.forename: Xin-Fan
authors.initials: XF
authors.lastname: Liu
authors.forename: Zi-Hao
authors.initials: ZH
authors.lastname: Yu
authors.forename: Da-Zhong
authors.initials: DZ
authors.lastname: Gu
authors.forename: Tu-Nan
authors.initials: TN
authors.lastname: Qian
authors.forename: Yong-Wen
authors.initials: YW
authors.lastname: Song
authors.forename: Jing
authors.initials: J
authors.lastname: Jin
authors.forename: Wei-Hu
authors.initials: WH
authors.lastname: Wang
authors.forename: Ye-Xiong
authors.initials: YX
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003110:Colonic Neoplasms / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000473:pathology* / Q000628:therapy; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome