PRIMARY GASTROINTESTINAL LYMPHOMAS - RESP ONSE TO ERADICATIVE THERAPYAND PROGNOSTIC FACTORS IN 52 PATIENTS

BACKGROUND: To analyze the response to eradicative therapy and prognos tic factors in 52 patients with primary gastrointestinal lymphoma (PGI L) diagnosed at a single institution in a 13 year period. PATIENTS AND METHODS: The main clinical, biological and evolutive data were record ed. Pathologic diagnosis of PGIL was made according to the Working For mulation. clinical stage was determined by the Ann Arbor system modifi ed by Mushoff. The results of therapy as well as the influence of such characteristics on complete remission (CR), disease-free survival (DF S) and overall survival (OS) were studied. RESULTS: Mean age of the se ries was 53 years (SD 15). Thirty patients were males. HIV infection p receded PGIL diagnosis in 10 cases, Seventeen had bad performance stat us (ECOG 2-4) and 30 B symptoms. The PGIL localization was gastric in 31 cases and 29 had a low grade malignant lymphoma. B phenotype was de monstrated in 98% and 22 patients presented advanced stages (IIE2-IV). Treatment was radical surgery followed by intensive chemotherapy in 3 2 cases, intensive chemotherapy alone in 17, and surgical resection in 3. CR was obtained in 34 patients and 6 of them relapsed. The project ed DFS from CR at 9 years was 72% and OS was 26%. CR and survival were not influenced by PGIL localization and treatment type. The main unfa vourable prognostic factors were advanced stage (CR and OS), B symptom s (DFS and OS) and advanced ECOG score (CR, DFS and OS). Previous HIV infection had an independent prognostic influence on both CR and OS. C ONCLUSIONS: In patients with PGIL, the achievement of CR, DFS and surv ival have been independent of the type of eradicative treatment used. Performance status, B symptoms and clinical stage have been the main p rognostic factors. HIV infection carried an independent prognostic sig nificance.