LONG-TERM FOLLOW-UP AFTER CURATIVE SURGERY FOR EARLY GASTRIC LYMPHOMA

Objective This study was designed to examine the long-term survival of a homogenous group of patients with stage IE or IIE-1 gastric lymphom a after complete surgical resection. Summary Background Data The manag ement of gastric lymphoma remains controversial. Enthusiasm for multim odality approaches for gastric lymphoma has lead to the current trend of using chemotherapy as primary treatment, thus avoiding gastric rese ction. Surgery, however, may result in improved long-term survival rat es. Methods The records of all patients with the diagnosis of gastric lymphoma from 1980 to 1991 were reviewed retrospectively. Of 106 patie nts examined, 34 underwent curative resection and regional lymphadenec tomy for pathologically staged IE or IIE-1 (pN1) gastric lymphoma. Fif teen patients underwent surgery alone, whereas 19 also received postop erative adjuvant therapy. Results The median follow-up time was 74 mon ths. The 10-year actuarial disease-free survival was 91% for stage IE disease (n = 23) and 82% for stage IIE-1 disease(n = 11). There were n o operative deaths and a 26% morbidity rate. No difference in survival was found for those treated with adjuvant therapy. Conclusions The re sults compare favorably to those reported with the use of primary chem otherapy and radiation therapy and suggest that surgery remains the be st frontline therapy for early gastric lymphoma.