DIAGNOSIS AND MANAGEMENT OF STAGE-IE AND STAGE-IIE GASTRIC LYMPHOMAS

We performed a retrospective study involving 56 patients with stage IE or stage IIE gastric lymphomas treated between January 1980 and Janua ry 1990. Endoscopy had a sensitivity of 98% compared with 83% for radi ographic contrast studies. The data were analyzed with respect to 10 p rognostic factors. Age greater than 65 years and an elevated lactate d ehydrogenase level were associated with a significantly lower 5-year s urvival rate (each p = 0.001). Those patients having had gastric resec tion with grossly negative margins demonstrated improved survival comp ared with those patients who did not have complete resection (67% vers us 29%). The use or omission of radiotherapy had no effect on survivor ship (51% versus 55%). Neither tumor size, stage, sex, site of extraga stric involvement. time from onset of symptoms to diagnosis, nor micro scopic resection margins influenced survival. We conclude that endosco py with biopsy is the diagnostic procedure of choice for gastric lymph oma. Gastric resection still plays an important role in the management of stage IE and stage IIE gastric lymphomas, whereas chemotherapy rem ains the mainstay of therapy. The role of radiotherapy remains undefin ed.