Skip to main content
SpringerLink
Log in

Prognostic Factors in Primary Gastric Lymphoma

  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

There is not a gold standard in the treatment of primary gastric lymphoma (PGL). This study aimed to establish prognostic factors that should be considered for the staging and management of this disease.

Methods

We retrospectively reviewed and analyzed the clinicopathological features of patients treated for PGL in a tertiary referral center in Mexico City in a 10-year period from 1990 through 2000. Staging was performed with the Ann-Arbor system. Overall and disease-free survivals were the primary endpoints.

Results

We identified 41 patients of which 19 (46.3%) were classified as large-cell lymphoma, 16 (39.0%) as low-grade MALT, and 6 (14.6%) patients as lymphoma unspecified. The series included 15 (36.6%) patients with stage IV disease. Twenty patients (48.8%) underwent surgery and 34 (82.1%) received chemotherapy. Twenty-three patients were treated with at least two different types of therapy (56.1%). Actuarial 1 and 5 years survival were 77.8 and 71.2%, respectively. Early stage at presentation, surgery, normal lactic dehydrogenase (LDH) levels and good performance status were associated with longer survival in univariate analysis. Only normal LDH and good performance status retained their significance in multivariate analysis. Regarding disease-free survival in multivariate analysis, only normal LDH was associated with a better prognosis: 131 versus 12 months for LDH <197 and ≥197 mg/dl, respectively (P < 0.0001).

Conclusions

Optimal treatment of PGL remains controversial. High LDH levels and poor performance status at diagnosis are associated with shorter overall and disease-free survival and should be considered for the staging and management of these patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

FIG. 1.
FIG. 2.
FIG. 3.
FIG. 4.

Similar content being viewed by others

References

  1. Al-Akwaa AM, Siddiqui N, Al-Mofleh IA. Primary gastric lymphoma. World J Gastroenterol 2004; 10:5–11

    PubMed  Google Scholar 

  2. Nakamura S, Matsumoto T, Lida M, Yao T, Tsuneyoshi M. Primary gastrointestinal lymphoma in Japan: a clinicopathologic analysis of 455 patients with special reference to its time trends. Cancer 2003; 97:2462–2473

    Article  PubMed  Google Scholar 

  3. Kodera Y, Yamamura Y, Nakamura S, et al. The role of radical gastrectomy with systematic lymphadenectomy for the diagnosis and treatment of primary gastric lymphoma. Ann Surg 1998; 227:45–50

    Article  PubMed  CAS  Google Scholar 

  4. Ranaldi R, Goteri G, Baccarini MG, Mannello B, Bearzi I. A clinicopathological study of 152 surgically treated primary gastric lymphomas with survival analysis of 109 high grade tumours. J Clin Pathol 2002; 55:346–351

    PubMed  CAS  Google Scholar 

  5. Koch P, del Valle F, Wolfgang B, et al. Primary Gastrointestinal non-Hodgkin’s lymphoma: I. Anatomic and histologic distribution, clinical features, and survival data of 371 patients registered in the German Multicenter Study GIT NHL 01/92. J Clin Oncol 2001; 19:3861–3873

    PubMed  CAS  Google Scholar 

  6. Seydel J, Ullrich A, Bender R, Fischbach W, Blettner M. Helicobacter pylori and carcinogenesis of gastic B-cell lymphomas. Int J Cancer 2003; 104:646–649

    Article  PubMed  CAS  Google Scholar 

  7. Yoon SS, Coit DG, Portlock CS, Karpeh MS. The diminishing role of surgery in the treatment of gastric lymphoma. Ann Surg 2004; 240:28–37

    Article  PubMed  Google Scholar 

  8. Chen LT, Lin JT, Shyu RY, et al. Prospective study of Helicobacter pylori eradication therapy in stage IE high-grade mucosa-associated lymphoid tissue lymphoma of the stomach. J Clin Oncol 2001; 19:4245–4251

    PubMed  CAS  Google Scholar 

  9. Raderer M, Chott A, Drach J, Montalban C, et al. Chemotherapy for management of localized high-grade gastric B-cell lymphoma: how much is necessary? Ann Oncol 2002; 13:1094–1098

    Article  PubMed  CAS  Google Scholar 

  10. Koch P, del Valle F, Wolfgang BE, et al. Primary gastrointestinal non-Hodgkin’s lymphoma: II. Combined surgical and conservative management only in localized gastric lymphoma—results of the prospective German Multicenter Study GIT NHL 01/92. J Clin Oncol 2001; 19:3874–3883

    PubMed  CAS  Google Scholar 

  11. Bozer M, Eroglu A, Unal E, Eryavuz Y, Kocaoglu H, Demirici S. Survival after curative resection for stage IE and IIE primary gastric lymphoma. Hepatogastroenterology 2001; 48:1202–1205

    PubMed  CAS  Google Scholar 

  12. Kelessis NG, Vassilopoulos PP, Bai MP, Agnantis NJ, Avital SR, Rosenthal RJ. Update of the role of surgery in the multimodal treatment of MALT gastric lymphomas. Anticancer Res 2002; 22:3457–3464

    PubMed  Google Scholar 

  13. Brands F, Moing SP, Raab M. Treatment and prognosis of gastric lymphoma. Eur J Surg 1997; 163:803–813

    PubMed  CAS  Google Scholar 

  14. Aviles A, Nambo JM, Neri N, et al. The role of surgery in primary gastric lymphoma: results of a controlled clinical trial. Ann Surg 2004; 240(1):44–50

    Article  PubMed  Google Scholar 

  15. Stephens J, Smith J. Treatment of primary gastric lymphoma and gastric mucosa-associated lymphoid tissue lymphoma. J Am Coll Surg 1998; 187:312–320

    Article  PubMed  CAS  Google Scholar 

  16. Harris NL, Jaffe ES, Diebold J, et al. World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissued: report of the Clinical Advisory Committee Meeting—Ailie House, Virginia, November 1997. J Clin Oncol 1999; 17:3835–3849

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Division of Surgical Oncology, National Institute of Medical Sciences and Nutrition “Salvador Zubiran”, Vasco de Quiroga 15, Tlalpan, Mexico City, 14000, Mexico

    Heriberto Medina-Franco MD & Santos Soto Germes MD

  2. Department of Pathology, National Institute of Medical Sciences and Nutrition “Salvador Zubiran”, Mexico City, Mexico

    Carmen Lome Maldonado MD

Authors
  1. Heriberto Medina-Franco MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Santos Soto Germes MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Carmen Lome Maldonado MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Heriberto Medina-Franco MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Medina-Franco, H., Germes, S.S. & Maldonado, C.L. Prognostic Factors in Primary Gastric Lymphoma. Ann Surg Oncol 14, 2239–2245 (2007). https://doi.org/10.1245/s10434-006-9244-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-006-9244-0

Keywords

Search

Navigation