Survival after curative resection for stage IE and IIE primary gastric lymphoma

Background/Aims: There is considerable controversy regarding the optimal tr eatment of patients with primary gastric lymphomas. However, surgery still plays an important role in the management of stage IE and IIE gastric lymph omas. We aimed at assessing survival of primary gastric lymphoma cases with stage IE or IIE that were surgically treated at the Surgical Oncology Depa rtment. Methodology: Thirty-seven patients with stage IE and HE primary gastric lym phoma who were surgically treated and had complete follow-up from January 1 990 to September 1998 were reviewed retrospectively. Patients' age, gender, tumor location, tumor grade, histologic type, depth of tumor invasion, reg ional lymph node status, tumor stage, type of gastrectomy (total/subtotal), combined resection, extensive lymphadenectomy, adjuvant chemotherapy were used as the clinicopathologic variables. Results: Five-year survival rates for stage IE and stage IIE disease were 7 5% and 37%, respectively. The overall 5-year survival rate of the patients was 57%. Univariate analysis demonstrated that age, tumor stage, and type o f gastrectomy were associated with prognosis, but only type of gastrectomy (subtotal gastrectomy) and tumor stage were found to be independent prognos tic factors (P <0.05). Conclusions: To obtain prolonged survival we recommend radical resection wi th extensive lymphadenectomy for malignant lymphoma stages IE and IIE. Pati ents with small distal lymphomas of the stomach can be treated with subtota l gastric resection.