TY - JOUR PY - 1994// TI - The role of surgery in primary gastric lymphoma JO - Chirurgia (Turin, Italy) A1 - Caravati, F. A1 - Furlan, L. A1 - Ginelli, S. A1 - Diurni, M. A1 - Calvi, A. SP - 498 EP - 502 VL - 7 IS - 7-8 N2 - From 1987 through 1991, 83 patients (45 males and 38 females) with primary gastric lymphoma were examined. The histologic findings for all 83 patients were reviewed. All cases observed were non-Hodgkin's lymphomas. The diagnosis was established by endoscopy with multiple biopsies in all patients except two. The most common site of the gastric lesion was the antrum (33 patients). The size of the gastric lesion ranged from 2 to 13 cm in diameter. Forty patients had a resection and multiple biopsies of the liver, spleen, bone marrow and abdominal lymph nodes. Twenty six patients underwent total gastrectomy, eight patients had a gastric resection and in 5 cases the gastrectomy was enlarged to other organs involved by direct extention. The operative mortality rate was 5% overall (7.5%) considering one suicide). Surgical therapy was followed by local regional radiotherapy for stage IE; chemotherapy for stage IIE. Stages III and IV were treated by radical or palliative surgical resection followed by polichemotherapy until complete remission in addition to 2 consolidation cycles. Endoscopy allows a correct diagnosis in the vast majority of patients (87.5% in our series). The procedure of choice in gastric lymphoma is the resection with 5 cm of minimal distance from the tumor, but often a total gastrectomy (26 cases on 40 operated patients) is necessary. Surgical exploration is mandatory for a correct staging of the tumor and to distinguish between gastric involvement of malignant systemic lymphomas and primary gastric lymphomas. The histological examination of the specimen allows a precise staging of the lymphoma. Only in low grade maltoma we adopt a conservative strategy with endoscopic monitoring.

Language: it

LA - it SN - 0394-9508 UR - http://dx.doi.org/ ID - ref1 ER -