A PROSPECTIVE-STUDY OF SURGERY AND ADJUVANT CHEMOTHERAPY FOR PRIMARY GASTRIC LYMPHOMA STAGE-II

The standard management of primary gastric lymphoma (PGL) (stage II) h as not been established despite the use of various treatment modalitie s. The present prospective trial of combined surgery and chemotherapy for the treatment of PGL (stage II) included 25 consecutive patients t reated between July 1978 and December 1993. Twenty-one patients were t reated with total gastrectomy and four with partial gastrectomy; this was followed by post-operative chemotherapy with m-VEPA (vincristine, cyclophosphamide, prednisolone and doxorubicin), followed by consolida tion chemotherapy with VEMP (vindesine, cyclophosphamide, methotrexate and prednisolone) or VQEP (vindesine, carbazilquinone, cyclophosphami de and prednisolone). Twenty-one of the 25 patients who completed post -operative chemotherapy were free of relapse 26-203 (median 94) months after the gastrectomy. Of the four patients who did not complete the projected chemotherapy, two relapsed and died of lymphoma. Another pat ient with recurrent lymphoma died in an accident, and the fourth patie nt was in remission at 54 months after surgery. The post-operative ove rall and disease-free survival rates at 10 years for the 25 evaluable patients were 81.6% and 92.0% respectively. Major surgical complicatio ns and treatment-related death after chemotherapy were not observed. P GL (stage II) appears to be curable when treated with gastrectomy and adjuvant chemotherapy.