PRIMARY GASTRIC LYMPHOMA IN CLINICAL-PRACTICE 1973-1992

This study assessed the presentation, treatment, and prognosis of prim ary gastric lymphoma in general hospital practice and its relation to infection with Helicobacter pylori. The number of patients that would on the current recommendations have been suitable for H pylori eradica tion therapy was also examined. Ah lymphomas were graded according to a standard classification of gut lymphoma into high and low grade dise ase. Forty five patients (mean age 65 years) were identified. The over all five year survival was 40% with a trend in favour of an improved p rognosis for low grade and stage I disease. H pylori was present in 80 %. Only one of 18 patients with a low grade mucosa associated lymphoid tissue tumour had mucosal disease alone, which responded to omeprazol e and amoxycillin. Ah other patients had bulk disease. These patients were treated by surgery, chemotherapy or radiotherapy or a combination of these treatments. In district hospital practice, most cases of pri mary gastric lymphoma have bulk disease at presentation. Even in patie nts with low grade gastric lymphoma on histological examination, many on the current evidence would not be suitable for anti-H pylori therap y alone.