ADVANTAGE OF SURGERY AND ADJUVANT CHEMOTHERAPY IN THE TREATMENT OF PRIMARY GASTROINTESTINAL LYMPHOMA

Background: Surgery has been the mainstay of treatment for gastrointes tinal (GI) lymphoma. The role of adjuvant chemotherapy to surgery has not been clearly elucidated. Methods: The review covered 100 patients who were diagnosed with primary GI lymphoma and treated from 1980 to 1 993 at Providence Hospital (Southfield, MI), and Hartford and St. Fran cis Hospitals (Hartford, CT) with a median follow-up of 5 years. Forty -two patients were treated with surgery alone; 31 patients with surger y and adjuvant chemotherapy; 23 patients with primary chemotherapy, an d 4 patients received no treatment. Results: The 5-year actuarial surv ival based on the above treatments calculated by life-table analysis w ere 57%, 76%, 58%, and 0%, respectively. This series showed that surge ry with adjuvant chemotherapy significantly improved the 5-year actuar ial survival of patients with primary GI Lymphoma and that primary che motherapy showed comparable survival to surgery alone. There was no di fference in prognosis when comparing patients with different stage, gr ade, or location of disease in the GI tract. Conclusions: We recommend surgery when feasible with adjuvant chemotherapy as the mainstay of t reatment for primary GI lymphoma. However, if a patient presents with comorbid factors, primary chemotherapy offers an effective alternative . (C) 1997 Wiley-Liss, Inc.