Gastrointestinal lymphoma in adults: clinical features and management of 300 cases

Abstract

Background/aims: Gastrointestinal lymphoma is a rare disease. A study was conducted to assess its prevalence and clinical features in adult patients with lymphoma.

Methods: Retrospective analysis of 1352 patients with adult non-Hodgkin's lymphoma showed 300 (22%) cases with gastrointestinal involvement at initial presentation.

Results: Of the 185 patients with primary gastrointestinal lymphoma, 94 (51%) had gastric primary lymphoma and the rest (49%) had a lymphoma of intestinal origin. Patients with intestinal lymphoma were considerably younger (median age, 35.0 years), frequently had multifocal disease (14%), and had a 10-year survival rate of 48%. Cases with gastric primary lymphoma had a median age of 54.5 years (P < 0.001) and rarely had multifocal disease (1%; P < 0.001) but had an equal 10-year survival rate of 53% (P = 0.431). For both groups, the combined surgical resection followed by chemotherapy led to better 10-year survival (45%) compared with either modality used alone (0% and 35%, respectively; P < 0.05). Better survival was also noted in ambulatory patients, younger patients, those with localized disease, and those without intestinal perforation. Another 115 patients had gastrointestinal involvement secondary to disseminated disease with frequent high-grade histology (29%) and a poor 10-year survival rate of 22%.

Conclusions: Gastrointestinal involvement is relatively common in patients with adult lymphoma. Multimodality treatment appeared superior to therapy with either surgery or chemotherapy used alone.