Bellini Marcello, Salvatore Giuseppe, Di Palma Roberto, Cataneo Mario, Pede Alfredo, De Martino Ciro
Dipartimento di Chirurgia Generale e D'Urgenza Università degli Studi di Napoli Federico II.
Chir Ital. 2003 May-Jun;55(3):391-7.
The aims of this study were to contribute to the drawing up of guidelines for the therapeutic approach to primary gastric lymphoma and to identify the most effective sequence of treatment in the different stages of the disease. We conducted a retrospective analysis of the clinical data of 34 patients with primary gastric lymphoma admitted from 1993 to 2001 to the 4th General Surgery Department of the "Federico II" University in Naples. All the patients underwent surgical therapy and neoadjuvant or adjuvant chemotherapy. Patients were subdivided according to stage of disease, histological grade of malignancy and sequence of treatment. The 2- and 5-year overall survival rates were 94% and 68%., respectively. We observed a longer survival (81% at 5 years) in patients with IE-IIE stage disease (according to Mushoff's staging) than those with IIIE-IVE stages (56%). Patients with low and intermediate grade lymphoma (according to the working formulation) had a longer survival (83% and 71%, respectively) than patients with high-grade malignancies (55%). We noted that IE-IIE stage patients who underwent neoadjuvant chemotherapy and surgery survived longer (100%) than those in whom surgery preceded chemotherapy (66%), whereas IIIE-IVE stage patients in whom surgery was the first treatment survived longer (70%) than those in whom surgery followed chemotherapy (37%). On the basis of our experience, in patients with IE-IIE stages of disease chemotherapy should precede surgery while in patients with IIIE-IVE stages the inverse sequence is more effective in achieving longer survival rates.
本研究的目的是为制定原发性胃淋巴瘤的治疗方法指南做出贡献，并确定该疾病不同阶段最有效的治疗顺序。我们对1993年至2001年期间入住那不勒斯“费德里科二世”大学第四普通外科的34例原发性胃淋巴瘤患者的临床资料进行了回顾性分析。所有患者均接受了手术治疗以及新辅助或辅助化疗。患者根据疾病分期、恶性组织学分级和治疗顺序进行细分。2年和5年总生存率分别为94%和68%。我们观察到，根据穆肖夫分期处于IE-IIE期疾病的患者（5年生存率为81%）比处于IIIE-IV期的患者（56%）生存时间更长。低级别和中级别淋巴瘤患者（根据工作分类法）比高级别恶性肿瘤患者（55%）生存时间更长（分别为83%和71%）。我们注意到，接受新辅助化疗和手术的IE-IIE期患者比先进行手术再进行化疗的患者生存时间更长（100%），而IIIE-IV期患者中先进行手术的患者比先进行化疗再进行手术的患者生存时间更长（70%比37%）。根据我们的经验，对于IE-IIE期疾病的患者，化疗应先于手术，而对于IIIE-IV期患者，相反的顺序在实现更长生存率方面更有效。
