title: Clinicopathological study of primary gastric lymphomas in the central region of Tunisia, with survival analysis.
abstract: BACKGROUND
  Primary gastric lymphomas (PGL) are rare and represent only 5% of gastric malignancies, but are apparently increasing in incidence worldwide. Optimal treatment of PGL remains controversial. The aim of this study was to evaluate clinicopathological characteristics, prognostic factors, survival rates, and treatment modalities in Tunisian patients with PGL.
  
  
  METHODS
  We retrospectively analyzed data from patients treated for PGL in our hospital over an 18-year period (1994-2011).
  
  
  RESULTS
  Data from 128 patients with PGL were retrospectively analyzed. Eighty-four were males and the median age was 57 years (range 5-89 years). The mean BMI was 22.9 (15-39). A total of 40 patients (31.2%) had a poor performance status (PS). The antrum was the most commonly involved site (52 cases, 40.6%). The most frequent pathological subtypes were diffuse large-cell lymphomas (46.4%) and mucosa-associated lymphoid tissues (32%). Disease was localized (stages IE and IIE) in 97 patients (75.8%). Ninety-six patients were evaluable. Chemotherapy alone was used in 73 (76%) patients, with 76.7% achieving complete remission. During chemotherapy, there were no severe complications requiring urgent surgery. Actuarial five-year overall and event-free survival were 60.2 and 54.3% respectively. We found no statistically significant difference in survival between patients treated with surgery and those treated by a conservative strategy. In the multivariate study, age greater than 60 years, poor PS, and BMI less than 20 were significant prognostic factors for overall survival (P=0.04, 0.009, and <0.001, respectively).
  
  
  CONCLUSIONS
  Surgery provides no advantage for survival over conservative treatment. Age, PS, and BMI were effective prognostic factors.
authors.affiliation: aDepartment of Medical Oncology, Ibn El Jazzar Hospital, Kairouan Departments of bMedical Oncology cRadiology, Farhat Hached University Hospital, Sousse, Tunisia.
authors.forename: Imtinane
authors.initials: I
authors.lastname: Belaid
authors.forename: Imene
authors.initials: I
authors.lastname: Chabchoub
authors.forename: Nesrine
authors.initials: N
authors.lastname: Mejri
authors.forename: Hounaida
authors.initials: H
authors.lastname: Zaghouani
authors.forename: Rim
authors.initials: R
authors.lastname: Chafai
authors.forename: Faten
authors.initials: F
authors.lastname: Ezairi
authors.forename: Makrem
authors.initials: M
authors.lastname: Hochlaf
authors.forename: Olfa
authors.initials: O
authors.lastname: Gharbi
authors.forename: Leila B
authors.initials: LB
authors.lastname: Fatma
authors.forename: Slim B
authors.initials: SB
authors.lastname: Ahmed
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015992:Body Mass Index; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D005743:Gastrectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008223:Lymphoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D014416:Tunisia / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents