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Title: [Post-therapeutic evolution and prognostic factors of intestinal lymphomas, Retrospective analysis of 42 cases].
Author: Sánchez-Fayos MP, Hernández Guío C, Rivas MC, Outeiriño J, González-Campos C, Lobo F.
Journal: Sangre (Barc); 1993 Dec; 38(6):455-62. PubMed ID: 8171381.
Abstract:
PURPOSE: To evaluate in retrospect the response to therapy and long-term evolution of a series of primitive intestinal lymphomas. PATIENTS AND METHODS: The series was comprised of 42 patients diagnosed in our hospital during 1960-1962. The mean age was 34.5 years (range, 3-73), the M/F ratio was 21/21, and the histopathology distributes as follows: high grade (HG), 24 cases, low grade (LG), 12 cases, and mixed (LG/HG), 6 cases. B/T immunophenotype: 40/2. Staging: IE1,29 cases, IIE2-IV, 11 cases. The treatment applied in the series was classified in various types: ample surgical resection (aSR), 21 cases; partial surgical resection (pSR), 9 cases; abdominal radiation therapy (RT), 7 cases; monochemotherapy (MCT), 7 cases, and polychemotherapy (PCT), 28 cases. The correlation of clinicobiological variables with immediate response to treatment was evaluated by means of the chi square test, and the acturial post-therapeutic survival curves in accordance to the life tables, differences being calculated by the log rank test. RESULTS: Small intestine was the commonest site of involvement, 31 cases; ileocecal region, 7 cases; colon, 2 cases, and colon plus small intestine, 2 cases. Regardless of therapy type, complete remission (CR) was attained in 20 patients (47.5%), partial remission in 5; 11 cases were unresponsive (26.5%) and early death occurred in 6 instances (14.2%). The acturial post-therapeutic survival offered an 8-year expectancy of 47%. The correlation between immediate complete response and 16 clinico-biologic variables showed favourable significance for tumoral proliferation index (i.e., Pc10-positive cells < 15%) and for therapeutic regimens including PCT+aSR. On the other hand, the necessity of emergency surgery for diagnosis was a poor-risk factor. The correlation between a post-therapeutic survival and 19 other variables showed the following as favorable data: female sex, tumour proliferative index (i.e., Pc10-positive cells < 15%), the use of PCT+aSR, and attaining CR. Poor-risk factors were the need of emergency surgery, multicentric lymphomatous involvement and serum LDH rates 350 UI/L. Although immediate response (CR) and long-term results (survival) were better in the patients with favourable histology (LG+LG/HG) and in those with loco-regional disease (stages IE-IE1), the differences had no statistical significance, possibly due to the low number of cases. CONCLUSIONS: 1) Even though these findings should be carefully evaluated, dut to lack of homogeneity of the series and the fact of being a retrospective study, the rate of CR in this series (47.5%) is similar to that of current studies. 2) Female sex, type of therapy, multifocal involvement, the need of emergency surgery and high LDH levels have significant value in univariate analyses.

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