The Role of Surgery in Primary Gastric Lymphoma

Abstract

In patients with primary gastric diffuse large cell lymphoma and aggressive histology, diffuse large cell lymphoma in early stage SCT achieved good results, but surgery was associated with some cases of lethal complications. Thus it appears that CT should be considered the treatment of choice in this patient setting. Current clinical classifications of risk are not useful in defining treatment.

Primary colorectal lymphoma

“…Most authors believe that surgery provides important prognostic information through definitive staging, offers a chance for cure with or without adjuvant therapy, as well as helps to prevent complications such as hemorrhage, obstruction, and perforation [11,12,20]. However, recent experience with gastric lymphomas has advocated the use of chemotherapy as a mainstay therapy [21]. In fact, an OS advantage has been observed in patients treated with chemotherapy alone compared to patients who underwent surgery only or surgery followed by adjuvant chemotherapy [21].…”

“…However, recent experience with gastric lymphomas has advocated the use of chemotherapy as a mainstay therapy [21]. In fact, an OS advantage has been observed in patients treated with chemotherapy alone compared to patients who underwent surgery only or surgery followed by adjuvant chemotherapy [21]. The small number of patients investigated for PCL precludes any statistical analysis of OS and disease free survival (DFS) in alternative therapeutic subgroups (surgery alone, chemotherapy alone, or both).…”

El papel de la cirugía en el linfoma gástrico

“…En dos estudios recientes sobre este tema, en el 100% de los pacientes el diagnóstico se estableció con el endoscopio. En pacientes con MALT gástrico con una predilección por la submucosa, se recomienda hacer más biopsias fuera del sitio clínicamente afectado, con el fin de poder definir el tratamiento de manera más adecuada 2,3 . Por tal motivo la cirugía ya no se requiere para el diagnóstico 4 .…”

“…No hubo diferencias significativas con la cirugía y quimioterapia y la quimioterapia sola; pero con el uso de cirugía la presencia de complicaciones tardías relacionadas con el acto quirúrgico eran altas y en ocasiones graves. Por tal motivo se considera que la cirugía no tiene un papel importante como parte del tratamiento en esta neoplasia 2,3,[5][6][7][8] . .…”

MALT Lymphoma: Forget Surgery?

“…There is a discussion on the necessity of additional radiotherapy in these patients. Two prospective randomized trials did not detect a benefit from additional radiation [24,25]. It might be reserved for patients with an initial bulk or those revealing a residual lymphoma after R-CHOP.…”