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2007 Program and Abstracts | 2007 Posters
Primary Intestinal Lymphoma: Evaluation of Prognostic Factors and Treatment Outcomes
Richard R. Smith*1, Ashwani Rajput1, Steven Cai1, Francis Cannizzo2
1Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY; 2Surgical Oncology, Bay State Medical Center, Springfield, MA

Background and Objective. The gastrointestinal tract is the most common site for extra nodal non-Hodgkin's lymphoma. Gastric lymphoma represents 50-60% of all gastrointestinal lymphomas. Gastric lymphoma, however, differs from primary intestinal lymphomas in regards to clinical features and prognosis. Surgery has had a diminishing role in gastric lymphoma but its role in primary intestinal lymphoma is still to be fully defined. We report our experience with 108 patients with primary intestinal lymphoma managed in a multidisciplinary fashion over a 32 year period. Patients and Methods. From January 1972 to June of 2004 we identified 108 patients with primary intestinal lymphoma. Patients with HIV and tumors arising primarily in the stomach, esophagus, non visceral organs or mesentery were excluded. Patients were evaluated in a multidisciplinary conference and treated accordingly. Kaplan-Meier survival estimates were performed for each treatment group.Results. The treatment plan was broken down as follows: 58 patients received surgery followed by chemotherapy +/- radiation; 26 patients received chemotherapy +/- radiation; 19 patients with surgery +/- radiation; 1 patient received radiation only; and 4 patients received supportive care only. The most common presenting symptom was abdominal pain. The tumor was located in the duodenum in 8 patients (7.4%), the jejunum in 17 patients (15.7%), the ileocecal region in 34 patients (32%), the colon in 35 patients (32%), the rectum in 9 patients (8.3%) and multiple sites in 5 patients (4.6%). Fourteen percent of patient presented with stage I disease, 26% stage II, 16% stage III, and 44% stage IV.The median follow up of the censored patients was 6.7 years. The median overall survival of the total group was 5.4 years. The median overall survival of patients treated with surgery and chemotherapy was 6.8 years. The median overall survival of patients treated with chemotherapy alone was 4.5 years. The median overall survival of patients treated with surgery was 5.7 years. The percentage of patients rendered no evidence of disease was 66% in the surgery and chemotherapy group, 58% in the chemotherapy only group and 84% in the surgery alone group.Conclusions. We report one of the largest series of patients with primary intestinal lymphoma. Long term survival in patients with primary intestinal lymphoma is possible even in advanced stage disease. Surgery achieves a high rate of initial disease control in selected patients but multidisciplinary approach appears important for longer term survival.


2007 Program and Abstracts | 2007 Posters
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