Primary Gastrointestinal Non-Hodgkin's Lymphoma: A Retrospective Study with Emphasis on Prognostic Factors and Treatment Outcome.

PURPOSE The study was initiated to obtain epidemiologic data and information on anatomic and histologic distribution, clinical features, prognostic factors and treatment results in patients with primary gastrointestinal non-Hodgkin's lymphomas (PGI NHL). PATIENTS AND METHODS We carried out analysis of 208 patients of PGI NHL during the time period from January 1997 to January 2007 at the Clinical Oncology Department, Tanta University Hospital to evaluate clinical features and treatment outcome. RESULTS A total of 74.5% of patients had gastric NHL (PGL). Within the intestine, the small bowel and the ileocecal region were involved in 8.2% and 7.2% of the cases, respectively. Multiple gastrointestinal (MGI) involvement was in 6.3%. Approximately 84% of the PGI NHL were in stages IE/IIE. Forty percent of PGL were of low-grade mucosa-associated lymphatic tissue (MALT) type. Most intestinal NHL were of high grade NHL. The median follow-up time was 89.3 months. The site of origin, disease stage, complete resection of the tumor and histologic grade were the most important significant prognostic factors affecting disease-free (DFS) and overall survivals (OS). Numbers in intestinal lymphomas were too small for subanalyses. The OS and DFS after 5 years were 78.5% and 72.3% respectively in all patients with PGI NHL. CONCLUSIONS Primary gastrointestinal non-Hodgkin's lymphomas are heterogenous diseases. The number of localized PGL allowed for detailed analyses. Larger studies are needed for stages III and IV and for intestinal NHL. Although this is a retrospective study, a stomachconserving approach may be favored. KEY WORDS Gastrointestinal neoplasms - NHL - Gastrointestinal lymphoma - Prognostic factors - Survival.