[Non-Hodgkin's lymphoma of the stomach: surgical therapy and prognosis].

This study reports 43 patients (male: n = 17, female: n = 26) with non-Hodgkin's lymphoma of the stomach, who underwent surgery between 1. January 1977 and 31. December 1986. The main clinical symptoms were abdominal pain, weight loss and vomiting. Symptoms preceded diagnosis by 13 weeks. Barium meal and endoscopy were useful diagnostic procedures. The biopsy specimens indicated malignancy in 80% of cases. Operations performed were: total gastrectomy (n = 18), distal resection (B I: n = 4, B II: n = 14), partial duodenopancreatectomy (n = 3), proximal gastric resection (n = 1), local excision (n = 1) and explorative laparotomy (n = 2). Perioperative mortality was 0%. Peritonitis occurred in 1 patient due to leakage of the duodenal stump. According to the Ann-Arbor system we found stage I in 19, stage II in 10 and stage III in 14 cases. The histological type according to the Working Formulation showed low grade of malignancy in 15 and high grade of malignancy in 28 patients. All patients underwent postoperative chemotherapy and/or radiotherapy with respect to tumour staging and morphology. 24 patients are alive without relapse, 16 patients died intercurrently. The data were collected retrospectively and analysed by means of Kaplan-Meier survival functions. For comparisons we used the Breslow and the Mantel test. We investigated the prognostic significance of: sex, clinical symptoms, localisation of the tumour, type and radicality of operation, lymphadenectomy, splenectomy, splenic infiltration, tumour size and depth of infiltration, staging and grading. The 2-year survival rate was 82%, the 5-year rate was 55%.(ABSTRACT TRUNCATED AT 250 WORDS)