COMBINED SURGERY AND CHEMOTHERAPY IN PRIMARY GASTRIC NON-HODGKINS-LYMPHOMA - A RETROSPECTIVE STUDY IN 66 PATIENTS

Sixty-six consecutive patients with primary gastric non-Hodgkin's lymp homa are reported. All patients underwent surgery which consisted of r adical resection in 23 patients (36%) and partial or palliative excisi on in the remaining 43 cases (36 and 7 respectively). Three patients d ied before starting chemotherapy, two refused the treatment and 61 com pleted the postoperative chemotherapeutic programme. We analysed this group of patients in order to assess the efficacy of chemotherapy foll owing surgery. Chemotherapy included either CVP or the original protoc ols from our institution. Excluding patients who underwent radical res ection, postoperative chemotherapy induced complete remission in 87% o f the remaining 39 patients. After a median follow-up of 84 months (ra nge 6-216), the 10-year cause-specific survival was 90% with a stable curve plateau after about 25 months. The survival was only influenced by response to therapy (p < 0.0001). The disease-free survival for pat ients who were not radically resected was 93%. We encountered only two relapses after 15 and 32 months. One of these was local and the other systemic. Our results indicate that chemotherapy following surgery in duces long-term remission and survival in primary gastric lymphoma and in particular improves remission and survival in stage II. In our opi nion, surgery may also be fundamental for the treatment of gastric lym phoma in the majority of cases.