Primary G astrointestinal N on-Hodgkin's L ymphoma: I I. Combined S urgical a nd C onservative o r C onservative Management O nly i n L ocalized G astric Lymphoma—Results o f t he P rospective G erman M ulticenter Study G IT N HL 0 1/92

Purpose: The aim of the study was to obtain data on anatomic and histologic distribution, clinical features, and treatment results of patients with primary gastro- intestinal non-Hodgkin's lymphomas, particularly com- bined surgical and conservative treatment (CSCT) ver- sus conservative treatment (CT) alone for primary gastric lymphoma (PGL) in localized stages. Patients and Methods: Whether the treatment in- cluded surgery was left to the discretion of each partic- ipating center. Radiotherapy (Rx) and chemotherapy were stratified according to histologic grading, stage, and the inclusion or omission of surgery as follows: patients with low-grade PGL were treated with extend- ed-field (EF) Rx (30 Gy). In case of residual tumor after surgery or in case of CT only (in stage IIE after six cycles of cyclophosphamide, vincristine, and prednisone), an additional boost of 10 Gy was given. All patients with high-grade PGL were treated with four (stage IE) or six (stage IIE) cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone followed by EF Rx (stage IE) or involved-field (IF) Rx (stage IIE). Rx dosage corre- sponded to low-grade NHL. Results: Between October 1992 and November 1996, 106 patients had CT only. The survival rate (SR) after 5 years was 84.4% and was influenced neither by patients' characteristics nor by stage or histologic grade. Seventy-nine patients had CSCT. Their SR was 82.0%. Complete resection of the tumor (R0) was prog- nostic for the overall survival (P.0165) as compared with incomplete resection. Conclusion: Although the study was not random- ized, a stomach-conserving approach may be favored. J Clin Oncol 19:3874-3883. © 2001 by American Society of Clinical Oncology.