PRIMARY NON-HODGKIN-LYMPHOMA OF THE LARGE-BOWEL

PURPOSE: To characterize the natural history of primary non-Hodgkin ly mphoma of the large bowel and identify prognostic factors. MATERIALS A ND METHODS: Twenty-three patients with primary non-Hodgkin lymphoma ac cording to strict criteria were identified. Seventeen patients underwe nt resection, and six patients underwent biopsy. Among 19 patients wit h intermediate-or high-grade lymphoma, 13 had diffuse large cell lymph oma. Ann Arbor stage was I in 15 cases, II in seven cases, and IV in o ne case. In 15 patients, the International Prognostic Index was availa ble: 0, eight patients; 1, six patients; and 3, one patient. Postopera tively, six patients received combined chemotherapy and radiation ther apy, eight patients received chemotherapy, and six patients received r adiation therapy. Overall and relapse-free survival were calculated ac tuarially, and univariate analysis was performed with regard to stage, treatment, extent of surgery, and the International Prognostic Index. RESULTS: Median follow-up was 144 months. Two patients' disease recur red. Overall and relapse-free survival at 10 years were 61% and 82%, r espectively. The International Prognostic Index was the only significa nt prognostic factor for overall survival (P = .03, log-rank test). CO NCLUSION: The prognosis of primary non-Hodgkin lymphoma appears to be as good as that of low- or intermediate-grade lymphoma. The only signi ficant prognostic factor for overall survival is the International Pro gnostic Index.