Abstract: Objective:To investigate the treatment methods for primary gastric lymphoma (PGL) and analyze the prognostic factors. Methods:The clinical data of 55 patients with PGL who were admitted to the First Affiliated Hospital of Dalian Medical University from July 2002 to December 2007 were retrospectively analyzed. Operation, medication or operation combined with medication were applied to patients according to the pathological type, clinical staging, infection of helicobacter pylori and complications. Patients were followed up via phone call till February 2013, and the location, diameter, pathological type, clinical stage of the PGL and the treatment methods were recorded for prognostic analysis. The survival rate was calculated by KaplanMeier method, and the univariate analysis of survival was done by Logrank test. Multivariate analysis was done by COX regression model.
Results:The PGL located at the gastric antrum in 26 cases, body of the stomach in 17 cases, fundus of the stomach in 5 cases, gastric cardia in 3 cases, body and antrum of the stomach in 4 cases. There were 46 patients with ulcerous PGL, 5 with nodular PGL and 4 with diffused and infiltrated PGL. There were 53 B cell lymphoma, 1 T cell lymphoma and 1 undefined tumor. Of the 53 patients with B cell lymphoma, 36 were with mucosaassociated lymphoid tissue lymphoma (MALTL) and 17 with diffuse large Bcell lymphoma (DLBCL). There were 23 patients in stage Ⅰ, 23 in stage Ⅱ, 4 in stage Ⅲ and 3 in stage Ⅳ. Of the 55 patients, 23 received operation, 14 received medication, 17 received operation+medication, and 1 left untreated. Fiftythree patients had complete followup data. The median time of followup was 60 months (range, 7-132 months). The 1, 3, 5year cumulative survival rates were 91%, 79% and 72%. The results of univariate analysis showed that tumor diameter, pathological type and clinical staging were risk factors influencing the prognosis of PGL patients (χ 2=9.34, 6.59, 88.01, P<0.05), while the treatment methods did not influence the prognosis of PGL patients (χ 2=3.63, P>0.05). The results of multivariate analysis showed that DLBCL, clinical stages Ⅲ and Ⅳ were independent risk factors influencing the prognosis of PGL patients (OR=5.758, 2.231, 95% confidence interval: 2.536-13.073, 1.370-3.625, P<0.05).
Conclusion:Multidisciplinary team treatment should be recommended for PGL patients. Pathological type (DLBCL) and clinical stages (stage Ⅲ and Ⅳ) are the independent risk factors influencing the prognosis of PGL patients.