STAGE-I AND STAGE-II NON-HODGKINS-LYMPHOMA OF THE GASTROINTESTINAL-TRACT - RETROSPECTIVE ANALYSIS OF 79 PATIENTS AND REVIEW OF THE LITERATURE

We reviewed the medical records of 79 patients with primary gastrointe stinal lymphoma (GI-NHL), defined according to the criteria of Dawson et al. (without involvement of liver, spleen, peripheral or mediastina l lymph nodes, or bone marrow), observed and treated in our institutio n between 1973-90. The most common disease site was the stomach (70 pa tients), followed by the small bowel (five patients) and the large bow el (four patients). The stage was IE in 36 cases and IIE in 43. Radica l surgery or surgical debulking was the main therapeutic approach (67 patients); 12 patients received only chemotherapy, eight of whom had t umors considered unresectable at laparotomy. After surgery, most of th e patients received chemotherapy; radiotherapy (RT) was given to only four patients. Surgically calculated overall survival (OS) rates at 5 years for the patients treated with surgery plus chemotherapy were 64% (radical surgery) and 46% (surgical debulking with microscopic lympho ma residue). For the 12 patients treated with chemotherapy alone, OS a t 5 years was 0%. Our findings, in accordance with most published data , suggest that surgery, together with stage and tumor size, remains an important prognostic factor of survival in primary GI-NHL, especially when it is radical. In patients with negative prognostic factors (bul ky disease, high-grade histologic type, microscopic residue, and stage II), postoperative chemotherapy and RT decrease the risk of distant f ailure and local recurrence.