Articles

Primary Gastric Lymphoma: Clinicopathologic Study of Gastric Ly-phoma Casess and the Treatment Option of Choice

Abstract

Introduction: Lymphoma may involve the gastrointestinal tract either primarily or as a manifestation of extensively disseminated systemic disease. Stomach being the most frequent site of primary gastroin-testinal lyphoma, followed by the small bowel and colon respectively (1&2&3). For diagnosis of pi-mary small intestinal lymphoma (PSIL), one most satisfies the criteria specified by Dawson and co-workers.(5) Gastric lymphoma is a common presentation of non-Hodgkin’s lymphoma. Controversy reigns about many aspects of its classification and management, especially regarding roles for surgical resection.The aim of this study is evaluation of 5 years survival and methods of treatment of primary gastric lymphoma in a group of Iranian patients.
Methods:
The authors review the clinical features, staging, pathology, prognosis, and management of 30 patients with an emphasis on the role of chemotherapy, surgical resection and radiotherapy of 71 gastrointestinal lymphoma cases.
Results: A total of 30 patients (19 male and 11 female) with a mean age of 51 years and a range of 34 – 68 years were included in the study. The frequency of primary gastric lymphoma in our series was 42% of the total of primary gastrointestinal lymphoma. The overall survival rate was 47.8% at 5 years. Stag-ing usually was completed using noninvasive techniques. Patients with stage I or II disease were treated with Surgery (gastric resection) and chemotherapy showed improved Free Disease Survival (FDS) of 67% at 5 years. The five-year survival for stage I, II, III and IV patients were 87%, 61%, 25%, and 11% respectively, and the five-year survival for low grade and high grade were 91% and 56%, respec-tively. Stage III or IV and inoperable primary gastric lymphoma were treated with chemotherapy and radiotherapy showed improved Free Disease Survival (FDS) of 67% at five years. The five-year sur-vival for stage I, II, III, IV were 87%, 61%, 25% and 11% respectively, and the five year survival for low grade and high grade were 91% and 56% respectively.
Conclusion:
Early stage disease and high-grade Lymphoma have a better prognosis and patients who have complete surgical removal of primary tumor and chemotherapy.

Aisenberg AC. Coherent view of non-Hodgkin's lymphoma. J Clin Oncol. 1995; 13: 2656-2675.

Nakamura S, Akazawa K, Yao T, et al. A clinicopa- thologic study of 233 cases with special reference to evaluation with the MIB-1 index. Cancer. 1995; 76: 1313-1324.

d'Amore F, Brincker H, Gronbaek K, et al. Non- Hodgkin's lymphoma of the gastrointestinal tract: a popu- lation-based analysis of incidence, geographic distribu- tion, clinicopathologic presentation features, and progno- sis. Danish Lymphoma Study Group. J Clin Oncol. 1994; 12: l673-l684.

Frazee RC, Roberts J. Gastric lymphoma treatment: medical versus surgical. Surg Clin North Am. 1992; 72: 423-431.

Rohatiner A, d'Amore F, Coiffier B, et al. Report on a workshop convened to discuss the pathological and staging classifications of gastrointestinal tract lymphoma. Ann Oncol. 1994; 5: 397-400.

Cogliatti SB, Schmid U, Schumacher U, et al. Pri- mary B-cell gastric lymphoma: a clinicopathological study of 145 patients. Gastroenterology. 1991; 101: 1159-1170.

Rosenberg SA. Classification of lymphoid neo- plasms [editorial; comment]. Blood. 1994; 84: 1359- 1360.

Doyle TC, Dixon AK. Pointers to the diagnosis of gastric lymphoma on computed tomography. Australas Radiol. 1994; 38: 176-178.

Kitamura K, Yamaguchi T, Okamoto K, et al. Early gastric lymphoma: a clinicopathologic study of ten pa- tients, literature review, and comparison with early gas- tric adenocarcinoma. Cancer. 1996; 77: 850-857.

Venzelos I. Tamiolakis. D.Bolioti. S.Nikolaidous. S. Lambropoulou.M. Alexiadis.G. Primary gastric Hodg- kin"s lymphoma: Acase report and review of the litera- ture. 2005; 46(1): 45.

Isaacson, PG.Du, MQ.MALT lymphoma: from mor- phology to molecules. Nat Rev Cancer 2004; 4: 644.

Paul C Schroy, III, MD Arnold S Freedman, MD. Clinical presentation and diagnosis of gastrointestinal lymphomas. 2005.

Koch P., Del Valle F., Berdel WE. et al. Primary gastrointestinal non-hodgkin"s lymphoma: anatomic and histologic distribution, clinical features ,and survival data of 371 patients registered in the german multicenter study git nhl 01/92. J Clin Oncol. 2001; 19: 3861.

Aul,MJ, Buell,JF, Peddi,VR, et al. MALToma: a Helicobacter pylori-associated malignancy in transplant patients:a report from the Israel Penn International Transplant Tumor Registry with a review of published literature Transplantation. 2003; 75: 225.

Asyia Ahmad MD., Yogesh Govil M.D., MRCP (UK), and Barbara B.Frank, M.D.: Gastric Mucosa- Associated Lymphoid Tissue Lymphoma. The American Journal of Gastroentrology. 2003 by Am Coll of Gastro- enterology .Published by Elesevier Inc.

Tanaka Y, Takao T, Watanabe H. Early stage gastric lymphoma: is operation essential? World J Surg. 1994; 18: 896-899.

Hammel P, Haioun C, Chaumette MT, et al. Efficacy of single-agent chemotherapy in low-grade B-cell mu- cosa-associated lymphoid tissue lymphoma with promi- nent gastric expression. J Clin Oncol. 1995; 13: 2524- 2529.

Bozzetti F, Audisio RA, Giardini R, et al. Role of surgery in patients with primary non-Hodgkin's lym- phoma of the stomach: an old problem revisited. Br.J.Surg. 1993; 80: 1101-1106.

Shchepotin IB, Evans SR, Shabahang M, et al. Pri- mary non-Hodgkin's lymphoma of the stomach: three radical modalities of treatment in 75 patients. Ann Surg Oncol. 1996; 3: 277-284.

Parsonnet J, Hansen S, Rodriguez L, et al. Helico- bacter pylori infection and gastric lymphoma. N Engl J Med. 1994; 330: 1267-1271.

Roggero E, Zucca E, Pinotti G, et al. Eradication of Helicobacter pylori infection in primary low-grade gas- tric lymphoma of mucosa-associated lymphoid tissue. Ann Intern Med. 1995; 122: 767-769.

Wotherspoon AC, Doglioni C, Diss TC, et al. Re- gression of primary low-grade B-cell gastric lymphoma of mucosa-associated lymphoid tissue type after eradica- tion of Helicobacter pylori. Lancet. 1993; 342: 575-577. A. Zeidman MD,E Ramadan MD,Z Fradin MD,Z Dreznik MD,M Mittelman MD,etal: Primary Gastric lymphoma : a retrospective study. 2003.

S chreuder, MaxI., Hoeve, Masieke A.; Hebeda, Konnie M., Verdi JK et al :Mutual exclusion of t(11;18) (q21;q21) and numerical chromosomal aberration in the development of different types of primart gastric lym- phoma. British Journal of Hematology. 2003; 123(4): 590

Hitchcock, S, NG, AK, Fisher, DC, et al. Treatment outcome of mucosa-associated lymphoid tissue/marginal zone non-Hodgkin's lymphoma. Int J Radiat Oncol Biol Phys. 2002; 52: 1058.

Yoon, SS, Coit, DG, Portlock, CS, Karpeh, MS. The diminishing role of surgery in the treatment of gastric lymphoma. Ann Surg. 2004; 240: 28.

Schmidt, WP, Schmitz, N, Sonnen, R. Conservative management of gastric lymphoma: the treatment option of choice. Leuk Lymphoma. 2004; 45: 1847.

Aviles, A, Nambo, MJ, Neri, N, et al. The role of surgery in primary gastric lymphoma: results of a con- trolled clinical trial. Ann Surg 2004; 240:44.

Streubel, B, Ye, H, Du, MQ, et al. Translocation t(11;18)(q21;q21) is not predictive of response to chemo- therapy with 2CdA in patients with gastric MALT lym- phoma. Oncology. 2004; 66: 476.

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Keywords
Primary gastric Lymphoma Treatment

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How to Cite
1.
Azarm T, Kalantari H, Alimoghadam K, Jahani M. Primary Gastric Lymphoma: Clinicopathologic Study of Gastric Ly-phoma Casess and the Treatment Option of Choice. Int J Hematol Oncol Stem Cell Res. 1;2(3):18-22.