Primary gastrointestinal lymphoma is a rare disease, and its treatment is not firmly established. So, the authors reviewed the world literature of the primary gastrointestinal lymphoma, and collected cases published in te Korean Journal of the
Surgical
Society, and analyzed treatment options to deduce the optimal treatment for primary gastrointestinal lymphoma, based on the authors' own experience.
@ES The results were as follows.
@EN 1) In the English literature, the primary sites of lymphoma were reported to be stomach, small intestine, and large intestine in that order. In Korea, on the contrary, small intestine was themost prevalent site(43.7%), colon and
rectum(27.9%),
stomach(25.6%) were the next.
2) The ratio of male to female was 2 to 1.
3) The preoperative diagnosis of primary gastrointestinal lymphoma is extremely difficult because of its nonspecific symptoms and gross findings on radiologic studies and endoscopy; high index of suspicion is mandatory to establish the
diagnosis.
4) Ulcerative type was the most frequent gross type(40%).
5) Multicentricity Was 16~21%.
6) Among 132 cases, stage 1 was 42 cases(31.8%), stage 2 was 46 cases(34.8%), stage 3 was 26 cases(19.7%), and stage 4 was 18 cases(13.6%). Excellent prognosis was expected in stage 1 and 2(66.6%).
7) Every effort to resect the lymphoma curatively is waminted; palliative resection should be considered if curative resection is impossible. Surgeons should keep it in mind that the incidence of reactive lymphoid hyperplasia is high.
8) As postoperative adiuvant therapy, chemotherapy has been more frequently used than radiotherapy since 1980. Risk of recurrence outside the treatment field is probably higher than expected, so systemic chemotherapy as adjuvant treatment is
necessary
even in some cases of curative resection. A study to identify those high risk group is necessary.
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