MANAGEMENT OF STAGE IE PRIMARY GASTRIC LYMPHOMA

From 1975 to 1991, stage IE gastric lymphoma was diagnosed or treated in 40 patients at our institution. Thirty-five evaluable patients were the subject of this analysis (median age, 63 years). All histologic s pecimens were reviewed and classified according to the working formula tion. Immunohistochemical stains were performed in 33 of 35 cases. The following histologic subtypes were identified: 26 patients had diffus e large cell, 2 had diffuse mixed cell, and 7 had mucosa-associated ly mphocytic lymphoma (small lymphocytic lymphoma with features of MALT l ymphoma). Of the 35 patients, 30 (86%) underwent laparotomy, with subt otal or total gastrectomy performed in 29. After gastrectomy, 17 patie nts had radiation therapy, 3 had chemotherapy, 2 had radiation plus ch emotherapy, and 7 had no further treatment. Five patients were diagnos ed with endoscopic biopsy and had radiation therapy, chemotherapy, or both without further surgical treatment. The median follow-up period w as 69.2 months. The commonest presenting symptom was pain. The 5-year disease-free survival was 90% for the entire group and 88% for the 28 patients with working formulation intermediate histology. For patients with MALT lymphoma, the 5-year disease-free survival was 100%. The pr ognosis for patients with stage IE working formulation intermediate-hi stology gastric lymphoma is good and for those with stage IE MALT lymp homa, excellent.