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[Surgical therapy of non-Hodgkin lymphoma of the stomach].

The value of surgical treatment is less well defined in gastric lymphoma than in gastric carcinoma. Therefore, we analysed the outcome of 245 patients with gastric malignancies, which were treated from 1.1.1988 to 31.12.1995 in the Department of Surgery/Charité. Twenty patients suffered from a non-Hodgkin-lymphoma and only 14 (8%) were diagnosed correctly by preoperative endoscopical biopsy. Seven patients with limited lymphoma underwent primary surgical therapy (total gastrectomy n = 4, subtotal gastrectomy n = 3). Seven patients with disseminated lymphoma (stage EIII-IV) were treated by neoadjuvant chemotherapy (CHOP), that was followed by gastrectomy (R0: n = 2, R1: n = 4) or explorative laparotomy (n = 1). Five patients (25%) were diagnosed as undifferentiated carcinoma and underwent total gastrectomy with D2-lymphadenectomy (R0: n = 5). One patient (5%) underwent emergency surgery due to gastric perforation. One patient (5%) died in hospital due to insufficient anastomosis after total gastrectomy and preoperative chemotherapy. Nine patients with high-grade malignant lymphomas received postoperative chemotherapy. The 1-, 2,- and 5-year-survival-rate was 95%, 89% and 44%. Although, many questions are still open, surgical therapy remains an important option in the multimodal treatment of gastric lymphoma.