Primary gastrointestinal non-Hodgkin's lymphoma: II. Combined surgical andconservative or conservative management only in localized gastric lymphoma- Results of the Prospective German Multicenter Study GIT NHL 01/92

Purpose: The aim of the study was to obtain data on anatomic and histologic distribution, clinical features, and treatment results of patients with pr imary gastrointestinal non-Hodgkin's lymphomas, particularly combined surgi cal and conservative treatment (CSCT) versus conservative treatment (CT) al one for primary gastric lymphoma (PGL) in localized stages. Patients and Methods: Whether the treatment included surgery was left to th e discretion of each participating center. Radiotherapy (Rx) and chemothera py were stratified according to histologic grading, stage, and the inclusio n or omission of surgery as follows: patients, with low-grade PGL were trea ted with extended-field (EF) Rx (30 Gy). In case of residual tumor after su rgery or in case of CT only (in stage HE after six cycles of cyclophosphami de, vincristine, and prednisone), an additional boost of 10 Gy was given. A ll patients with (stage IIE) cycles of cyclophosphamide, doxorubicin, vincr istine, and prednisone followed by EF Rx (stage IE) or involved-field (IF) Rx (stage IIE). Rx dosage corresponded to low-grade NHL. Results. Between October 1992 and November 1996, 106 patients had CT only. The survival rate (SR) after 5 years was 84.4% and was influenced neither b y patients' characteristics nor by stage or histologic grade. Seventy-nine patients had CSCT. Their SR was 82.0%. Complete resection of the tumor (RO) was prognostic for the overall survival (P = .0165) as compared with incom plete resection. Conclusion: Although the study was not randomized, a stomach-conserving app roach may be favored. J Clin Oncol 19:3874-3883. (C) 2001 by American Socie ty of Clinical Oncology.