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ISRN Oncol. 2012;2012:951816. doi: 10.5402/2012/951816. Epub 2012 Aug 29.

Primary gastric lymphoma: conservative treatment modality is not inferior to surgery for early-stage disease.

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1
Division of Medical Oncology, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University, 34098 Istanbul, Turkey.

Abstract

OBJECTIVES:

The aim of this study was to evaluate clinical characteristics, prognostic factors, survival rates, and treatment modalities in patients with primary gastric lymphoma (PGL).

METHODS:

We retrospectively reviewed and analyzed data from patients treated for PGL in our clinic from 1998 through 2010. Staging was performed using the Lugano Staging System. Overall and disease-free survival (OS and DFS) were calculated from the date of diagnosis.

RESULTS:

We identified 79 patients. Thirty-seven patients (47%) were male. The median age at presentation was 57 (18-85) years. The median follow-up time was 41 (9-52) months. Thirty patients (38%) underwent surgery, 74 (92%) received chemotherapy, and 18 (23%) received radiotherapy. The five-year OS and DFS rates were 91.2% and 83.9%, respectively, in patients with stage I/II or IIE disease and 70.6% and 65.5%, respectively, in patients with stage IV disease (P = 0.02 for both rates). Treatment modality (surgical or conservative) had no impact on OS or DFS in early stages. In a multivariate analysis, poor performance status, advanced stage, and high LDH levels were significant bad prognostic factors for DFS, while advanced stage, poor performance status, and age > 60 years were significant bad prognostic factors for OS.

CONCLUSION:

Surgery provides no advantage for survival over conservative treatment; thus, conservative treatment modalities should be preferred initially at early stages of PGL.

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