Outcome and quality of life favour a conservative treatment of patients with primary gastric lymphoma.

BACKGROUND: Both surgical and conservative treatment strategies offer an excellent outcome to patients with gastric lymphoma. No comparison of surgical resection with primary radiation or chemotherapy on a prospective randomised basis was available up to now.

AIMS: The aim of this study was to compare surgery with radiation and surgery plus chemotherapy with chemotherapy alone in patients with marginal zone B-cell lymphoma (MZBCL) of MALT and diffuse large B-cell lymphoma (DLBCL), respectively, with respect to long-term outcome and quality of life.

METHODS: 49 patients [21 male and 28 female; age 65 (35 - 75) years] with newly diagnosed MZBCL of MALT (n = 19) and DLBCL (n = 30) of stage I and II were recruited. Outcome was evaluated after a follow-up of 74 (7 - 102) months and quality of life was measured using the SF-36 health survey and the gastrointestinal life quality index (GLQI).

RESULTS: Complete remission rates in MZBCL of MALT were 88 % and 89 % in patients treated by surgery or radiotherapy, respectively. The corresponding rates for patients with DLBCL were 93 % following surgery plus chemotherapy and 92 % after chemotherapy alone, respectively. The results in the different treatment groups did not differ significantly. Posttherapeutic quality of life was generally high with a significant advantage for patients treated conservatively compared to those who underwent surgery.

CONCLUSION: Long-term outcome of patients with gastric lymphoma is excellent irrespective of the lymphoma type and the treatment approach. Considering quality of life a conservative therapeutic strategy should be favoured.