Primary Gastrointestinal Lymphoma

Abstract

Primary gastrointestinal lymphomas represent a specific entity which must be differentiated from nodal non-Hodgkin’s lymphomas due to its significantly different biological behavior, prognosis and treatment. In localized disease (stages IE and IIE) surgery can yield curative results. While adjuvant therapy is not necessarily required in stage-IEl tumors, postoperative chemotherapy or radiation are mandatory in the other stages or in residual disease. Multimodal therapy in stages IE and HE results in favorable prognosis as indicated by a 5-year survival rate of 75-90 %. In disseminated disease (stages IIIE and IVE) primary intensive combination chemotherapy (CHOP) is the therapy of first choice. Additional radiotherapy may be beneficial to eradicate localized tumors. Surgical resection of the tumor may eliminate hazardous sequelae of this therapy, e.g. hemorrhage, perforation. Inspite of intensive therapy, the prognosis of advanced gastrointestinal (GI) lymphoma remains poor, resulting in a 5-year survival rate of 10-30%.