765 - Results of surgery of gastric lymphomas complicated with bleeding, stenosis and perforation

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Complications of Treatment
Lymphomas
Surgery and/or Radiotherapy of Cancer
Presenter Vasiliy Shalenkov
Authors V. Shalenkov, S. Nered, I. Stilidi
  • Abdominal Surgery, N. N. Blokhin Russian Cancer Research Center of Russian Academy of Medical Sciences, 115478/RU

Abstract

Background

Our purpose is to study results of surgery of patients with primary non-Hodgkin's lymphomas complicated with bleeding, stenosis and perforation.

Materials and methods

66 patients with primary non-Hodgkin's lymphomas were treated in our centre between 1984 and 2009 because of bleeding – 49, stenosis – 11, gastric perforation – 6. Group under study included 28 females and 38 males, mean age was 49. Bleedings from benign gastric ulcers and gastric perforations outside of tumor lesions' zones were excluded from the study. The histological types: diffuse large B cell lymphoma – 50 patients (76%), MALT-lymphoma – 12 (18,5%), Burkitt's lymphoma – 4 (6%). Localization of the lesions: overall – 29 patients (44%), antrum – 22 (33%), stomach's body – 9 (15%), proximal part – 6 (9%). 26 patients (39%) had stage I, 19 (29%) – II, 21 (31,5%) – IV. 45 patients (68%) had complications before chemotherapy, 8 (12%) – during the course, 13 (20%) – after. Patients after chemotherapy had gastric perforation more frequent (in 20% of cases) than chemo-naive patients (4,3%, p = 0,063). Gastrectomy was performed for 47 patients (71%), subtotal gastrectomy – 12 (19%).

Results

43 (65,1%) patients had radical operations, 14 (21,2%) had palliative gastrectomy or gastric resection, 4 (6%) had bypass operations and 5 (7,5%) had only explorative laparotomy. Overall postoperative mortality was 11%. 35% patients had postoperative complications. The most frequent complications were subdiaphragmatic abscess (5,2%), postoperative wound infection (5,2%) and pneumonia (5,2%). Overall 3-, 10- and 10-year survival rate in the group under study was 75%, 65% and 40%, respectively; median survival was 100 months. Patients after radical operations had higher three- and five-year survival rates than patients after palliative gastrectomies and resections (82% and 73% vs. 51% and 44%), however ten-year survival rates in both groups were practically the same.

Summary

Complications of gastric lymphomas can occur at any stage of the disease. Aggressive surgical approach allows to ablate affected organ and remove the source of fatal complications for 86% of patients. Due to postoperative chemotherapy, more than half of patients survive 5 years after surgery.

Disclosure

All authors have declared no conflicts of interest.