[Prognostic factors in gastric lymphoma].

Stomach is the most common site of extranodal lymphoma, but lymphoma's biology differs from other types of gastric cancer. From 1982 to 1994, 80 cases of primary gastric lymphoma were treated in Cancer Center in Kraków. In order to assess the best mode of treatment the retrospective analysis of disease related parameters was performed. Sixty four patients were primary treated with surgery, and 11 with radiotherapy. After surgery 21 patients received adjuvant chemo or radiotherapy. Radical resection of tumor was done in 37 cases, in next 25 only palliative surgery was possible. There was 28 cases of lymph node metastases in resected specimens. At 5 years, the overall survival was 64.4% with the median survival of 43 months. Patients primarily treated with surgery had better 5--years survival rates compared with others (72.1% and 36.8%, respectively-p < 0.05). The chance of survival was related with the tumor grading and 5 years survived 86.5% patients with well differentiated lymphomas, and 52.6% patients with nondifferentiated tumors. There was no influence on survivals other variables as duration of symptoms, type of surgery, histological margins or adjuvant therapy. The Cox multivariate analysis showed the grading, type of first treatment and lymph node status as the only three significant factors related to survivals. The relative risk of death for nondifferentiated lymphomas was 7 times higher, than for well differentiated tumors. The primary surgery (even nonradical) of gastric lymphoma is the best mode of treatment and the grading is the most important prognostic factor influencing the survivals.