Treatment Strategy for Primary Gastric Lymphoma

Tsuyoshi Kito, Yasuhiro Kodera, Yoshitaka Yamamura, Yasuhiro Shimizu, Akihito Torii, Takashi Hirai, Kenzo Yasui, Takeshi Morimoto, Tomoyuki Kato

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital

Over the past 31 years, 119 patients with primary gastric lymphoma were treated at Aichi Cancer Center Hospital. Clinicopathological features and survival data of these patients were analyzed. The patients were stratified into three groups: those treated with surgery alone, those given multimodal therapy, and those treated without surgery. The 5-year survival rate for the 26 patients receiving multimodal therapy was 64.0%. Of the 8 patients treated without surgery, one survived for 6 years with chemotherapy alone. The patients treated with surgery alone were further stratified into three categories; early disease, advanced disease, and mucosa-associated lymphoid tissue lymphoma. The standard surgical procedure throughout has been D2 dissection. All 10 patients belonging to the early disease group have survived for over 5 years to date, including a case with nodal metastasis. Of the patients belonging to the advanced disease group, 25 underwent curative resections, 7 of which were total gastrectomies. Nodal metastasis was observed in 72.0% of the 25 patients, and the 5-year survival rate was 75.0%. Of the 36 patients belonging to the MALT lymphoma group, 28 were treated with total gastrectomy. Nodal metastasis was found in 44.4%, and the 5-year survival rate was 91.6%. Adequate surgery, supplemented with multidisciplinary therapy where appropriate, has led to excellent treatment results for primary gastric lymphoma.

Key words
gastric lymphoma, treatment strategy of gastric lymphoma, lymph node metastasis of gastric lymphoma, mucosa-associated lymphoid tissue lymphoma, multidisciplinary treatment of gastric lymphoma

Reprint requests
Tsuyoshi Kito Department of Gastroenterological Surgery, Aichi Cancer Center
1-1 Kanokoden, Chikusa-ku, Nagoya, 464 JAPAN

Accepted
September 9, 1997

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