The role of surgery in the treatment of gastrointestinal lymphomas other than low-grade MALT lymphomas

Paolo G. Gobbi, Maria Laura Ghirardelli, Carla Cavalli, Luca Baldini, Chiara Broglia, Vera Clò, Raffaella Bertè, Fiorella Ilariucci, Mario Carotenuto, Lino Piccinini, Caterina Stelitano, Giuseppe Attardo-Parrinello, Edoardo Ascari

Research output: Contribution to journalArticlepeer-review

Abstract

Background and Objectives. A bias in clinical investigations on gastrointestinal lymphomas is the lack of testing the intention to treat as to resection, emergency conditions at presentation and selection brought about by the elevation of feasibility of surgery. Design and Methods. A prospective study involved 154 patients with gastrointestinal nodular or high-grade MALT lymphomas, 111 with a gastric and 43 with an intestinal presentation. The decision to resect or treat conservatively was left to clinicians, on condition that it was previously defined for each patient. Results. Failure-free survival was significantly higher in the 106 resected patients than in the 48 unresected ones but did not differ according to either primary intention to treat or emergency surgery/elective treatment. Survival was similar in patients operated on by choice and in those because of an emergency. Intentionally unresected patients had a significantly better survival than those not undergoing surgery despite the initial intention, for a number of clinical reasons. Patients with gastric lymphoma survived longer than those with intestinal disease and prognostic factors were analyzed separately in the two groups. The best predictors of prognosis were performance status and serum lactic dehydrogenase level in gastric lymphomas, resection alone in intestinal ones. Interpretations and Conclusions. The prognosis of gastric lymphomas depends on lymphoma-related factors and not on surgical treatment. The prognosis of intestinal ones is exclusively related to surgery. These data support the appropriateness of different clinical approaches to gastric and intestinal lymphomas. (C) 2000, Ferrata Storti Foundation.

Original languageEnglish
Pages (from-to)372-380
Number of pages9
JournalHaematologica
Volume85
Issue number4
Publication statusPublished - Apr 2000

Keywords

  • Gastric lymphoma
  • Intestinal lymphoma
  • Prognosis
  • Therapy

ASJC Scopus subject areas

  • Hematology

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