PubMed1984
We report the results of a diagnosis and treatment scheme used in 35 patients with primary gastrointestinal lymphoma studied between 1972 and 1982. There were 17 lymphomas of the stomach, 13 of the small bowel, 6 of the colon and/or the rectum. According to the Kiel classification and/or the International Working Formulation, 10 were "good risk" lymphomas, 25 were "bad risk" lymphomas. According to the Musshoff modified Ann Arbor staging classification, 16 were localized lymphomas (stage IE and II1E), 19 were disseminated lymphomas (stages II2E, IIIE or IV). The treatment scheme included laparotomy for staging and resection, total abdominal irradiation (until 1977), and polychemotherapy with or without adriamycin depending on histologic grade. The median survival was greater than the median follow-up with a survival plateau at 0.53 after 47 months. Amongst the prognostic factors studied, the digestive initial localization had no prognostic significance; on the other hand, survival depended on abdominal extension, histologic grade according to the classifications used for lymph-nodes lymphomas, and resection possibilities, and especially on achievement of complete remission. These good results emphasize the importance of combining surgical resection with chemotherapy and early assessment of the treatment in order to rapidly obtain complete remission, the way of achieving prolonged survival.