Prognostic factors in primary gastrointestinal non‐Hodgkin's lymphoma: a multivariate analysis of 76 cases

Objective: To present our experience with the treatment of primary gastrointestinal (GI) non‐Hodgkin's lymphoma, evaluate prognostic factors, and give our recommendations for treatment. Design: Retrospective study. Setting: Teaching hospital, Spain. Subjects: 76 patients (47 men and 29 women, mean age 51 years) treated over the 15 years 1980–1994. Interventions: 52 patients had radical resections, 19 palliative resections, and 5 biopsy alone. 42 (55%) also had adjuvant chemotherapy and 20 (26%) radiotherapy. Results: Patients with primary intestinal lymphoma were slightly but not significantly younger than those with gastric lymphoma (43 compared with 56 years). 43 Patients (57%) had tumours in the stomach, 26 (34%) in the small bowel, and 7 (9%) in the colon. At presentation 34 had stage I disease, 25 stage IIE1 disease, and the remaining 17 stage IIE2; 14 were classified as low grade, 41 as intermediate, and 21 as high grade. 60 (79%) had a B‐cell phenotype. Overall 5‐year survival was 53%. Of the 11 variables tested by univariate analysis for their prognostic effect only abdominal mass ( p < 0.001), clinical stage ( p < 0.001), type of operation ( p < 0.001), tumour size ( p < 0.05), and histological grade ( p < 0.05) achieved significance, but when Cox's multivariate analysis was applied only clinical stage was significant ( p < 0.01). Conclusion: Operation is the treatment of choice, but chemotherapy and radiotherapy may have a role though as yet there are no standard guidelines for their use. Copyright © 1998 Taylor and Francis Ltd.