title: Outcome and quality of life favour a conservative treatment of patients with primary gastric lymphoma.
abstract: BACKGROUND
  Both surgical and conservative treatment strategies offer an excellent outcome to patients with gastric lymphoma. No comparison of surgical resection with primary radiation or chemotherapy on a prospective randomised basis was available up to now.
  
  
  OBJECTIVE
  The aim of this study was to compare surgery with radiation and surgery plus chemotherapy with chemotherapy alone in patients with marginal zone B-cell lymphoma (MZBCL) of MALT and diffuse large B-cell lymphoma (DLBCL), respectively, with respect to long-term outcome and quality of life.
  
  
  METHODS
  49 patients [21 male and 28 female; age 65 (35 - 75) years] with newly diagnosed MZBCL of MALT (n = 19) and DLBCL (n = 30) of stage I and II were recruited. Outcome was evaluated after a follow-up of 74 (7 - 102) months and quality of life was measured using the SF-36 health survey and the gastrointestinal life quality index (GLQI).
  
  
  RESULTS
  Complete remission rates in MZBCL of MALT were 88 % and 89 % in patients treated by surgery or radiotherapy, respectively. The corresponding rates for patients with DLBCL were 93 % following surgery plus chemotherapy and 92 % after chemotherapy alone, respectively. The results in the different treatment groups did not differ significantly. Posttherapeutic quality of life was generally high with a significant advantage for patients treated conservatively compared to those who underwent surgery.
  
  
  CONCLUSIONS
  Long-term outcome of patients with gastric lymphoma is excellent irrespective of the lymphoma type and the treatment approach. Considering quality of life a conservative therapeutic strategy should be favoured.
authors.affiliation: Medizinische Klinik II, Klinikum Aschaffenburg. med2-aschaffenburg@t-online.de
authors.forename: W
authors.initials: W
authors.lastname: Fischbach
authors.forename: S
authors.initials: S
authors.lastname: Schramm
authors.forename: E
authors.initials: E
authors.lastname: Goebeler
mesh_terms: D000328:Adult; D000368:Aged; D004358:Drug Therapy / Q000401:mortality / Q000706:statistics & numerical data; D005260:Female; D005743:Gastrectomy / Q000401:mortality / Q000706:statistics & numerical data; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008223:Lymphoma / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D011878:Radiotherapy / Q000401:mortality / Q000706:statistics & numerical data; D013274:Stomach Neoplasms / Q000401:mortality* / Q000628:therapy*; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome