Management and long term results of surgery for localized gastric lymphomas

BACKGROUND: High- and low-grade gastric lymphomas (GL) differ in their beha vior and chemosensitivity. Surgery has to be reevaluated according to the h istologic grade of malignancy. We aimed to assess the place of surgery in t he management of GL and its results after longterm follow-up. METHODS: Among 54 patients with primary GL prospectively enrolled from 1984 to 1990, 45 with localized disease were studied. Primary resection was don e whenever safe. All patients received chemotherapy adapted to the grade of malignancy and/or to the completeness of the resection. RESULTS: Among 18 low- and 27 high-grade GL, 35 patients had primary resect ions; of those, 23 were complete. The complete response rate for all patien ts with low- and high-grade GL was 67% and 89%, respectively, After a media n follow-up of 8 years, the disease-free survival rates for low-grade GL an d high-grade GL were 94% and 89%, respectively. It was better after complet e resection. CONCLUSION: Complete resection is a major determinant of prolonged complete remission. (C) 2000 by Excerpta Medica, Inc.