Management of gastrointestinal lymphoma

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Abstract
A STUDY WAS MADE OF 85 PATIENTS WITH PRIMARY gastrointestinal (GI) lymphoma. The occurrence was 40 (62%) in stomach, 15 (23%) in the small intestine, and 10 (15%) in colorectum. The majority of patients had their histology classified according to Rappaport's classification. Diffuse histiocytic type had the worst prognosis (median survival 13.8 months), and nodular histology had the best prognosis. A modified staging system proposed by Black-ledge et al. was used. Patients who had their disease confined to one viscus (Stage I) or with spread to regional lymph nodes (Stage II) had an excellent prognosis, with a 5-year survival of 87 and 67%, respectively. However, those who had distant nodal involvement (Stage III, e.g., para-aortic nodes) or spread to adjacent organs within the abdomen (Stage IV) had worse prognosis, with 5-year survival of 40 and 13%, respectively. In Stage I, radiotherapy alone was as effective as surgical resection. None of the 11 patients treated by radiotherapy alone had perforation or bleeding. The 5-year disease-free survival was 51%.