Yonsei Med J.  2006 Feb;47(1):22-33. 10.3349/ymj.2006.47.1.22.

Clinicopathologic Characteristics and Therapeutic Outcomes of Primary Gastrointestinal Non-Hodgkin's Lymphomas in Central Anatolia, in Turkey

• Eser B
• Kaplan B
• Unal A
• Canoz O
• Altuntas F
• Sari HI
• Er O
• Ozkan M
• Kucuk C
• Arar M
• Gursoy S
• Cetin M

• KMID: 1715870
• DOI: http://doi.org/10.3349/ymj.2006.47.1.22

Abstract

Primary gastrointestinal lymphoma is a common presentation of non-Hodgkin's lymphoma. The main controversy arises when many aspects of its classification and management are under discussion, particularly regarding roles for surgical resection. The aim of this study was to evaluate clinicopathologic characteristics and the therapeutic outcome of primary gastrointestinal non-Hodgkin's lymphoma. We carried out a retrospective analysis of 74 patients who were presented to our center with histopathological diagnosis of primary gastro-intestinal non-Hodgkin's lymphoma between 1990 and 2001. All patients have been staged according to Lugano Staging System. For histopathological classification, International Working Formulation was applied. The treatment choice concerning the surgical or non-surgical management was decided by the initially acting physician. Treatment modalities were compared using the parameters of age, sex, histopathological results, stage, and the site of disease. Of the 74 patients, 31 were female and 43 were male, with a median age of 49 years (range 15-80). The stomach was the most common primary site and was seen in 51 of 74 patients (68.9%). The intermediate and high grade lymphomas constituted 91.9% of the all cases. In a median follow-up of 29 months (range 2-128), 20 out of 74 patients died. There was a three year overall survival rate in 65.4% of all patients. The three year overall survival rate was better in stage I and II1 patients who were treated with surgery plus chemotherapy (+/-RT) than those treated with chemotherapy alone (93.7% vs. 55.6%, p<0.05). The stage and presence of B symptoms affected the disease free survival and overall survival significantly, but the histopathologic grade only affected the overall survival. On the basis of these results, we suggest that surgical resection is necessary before chemotherapy in early stage (stage I and II1) patients with gastrointestinal non-Hodgkin's lymphomas because of the significant survival advantage it would bring to the patient.

Keyword

Gastrointestinal non-Hodgkin's lymphoma; prognostic factors; clinicopathologic features; survival

MeSH Terms

Turkey/epidemiology
Treatment Outcome
Survival Rate
Retrospective Studies
Neoplasm Staging
Middle Aged
Male
Lymphoma, Non-Hodgkin/mortality/*pathology/*therapy
Humans
Gastrointestinal Diseases/mortality/*pathology/*therapy
Female
Combined Modality Therapy/adverse effects
Aged, 80 and over
Aged
Adult
Adolescent

Figure

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  Fig. 1 Overall survival of all gastrointestinal non-Hodgkin's lymphoma patients.

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  Fig. 2 The effect of histopathological grades on overall survival in low, intermediate and high grade gastrointestinal non-Hodgkin's lymphoma.

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  Fig. 3 The overall survival of early and advanced stages gastrointestinal non-Hodgkin's lymphoma.

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  Fig. 4 The effect of the presence of B symptoms on overall survival.

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  Fig. 5 The effect of surgery on the overall survival in stage I-II1 gastrointestinal non-Hodgkin's lymphoma.

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  Fig. 6 The effect of surgery on the overall survival in advanced stages of gastrointestinal non-Hodgkin's lymphoma.

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