Prognostic factors in primary gastrointestinal non-Hodgkin's lymphoma. A multivariate analysis, report of 106 cases, and review of the literature

CancerVolume 64, Issue 6 p. 1208-1217 ArticleFree Access Prognostic factors in primary gastrointestinal non-Hodgkin's lymphoma. A multivariate analysis, report of 106 cases, and review of the literature Mohamed B. Azab MD, MSc, Corresponding Author Mohamed B. Azab MD, MSc Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceDepartment of Medicine A, Institut Gustave-Roussy, Rue Camille Desmoulins, 94805 Villejuif Cedex France===Search for more papers by this authorMichel Henry-Amar MD, Michel Henry-Amar MD Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceSearch for more papers by this authorPhilippe Rougier MD, Philippe Rougier MD Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceSearch for more papers by this authorCaroline Bognel MD, Caroline Bognel MD Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceSearch for more papers by this authorChristine Theodore MD, Christine Theodore MD Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceSearch for more papers by this authorPatrice Carde MD, Patrice Carde MD Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceSearch for more papers by this authorPhilippe Lasser MD, Philippe Lasser MD Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceSearch for more papers by this authorJean-Marc Cosset MD, Jean-Marc Cosset MD Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceSearch for more papers by this authorBernard Caillou MD, Bernard Caillou MD Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceSearch for more papers by this authorJean-Pierre Droz MD, Jean-Pierre Droz MD Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceSearch for more papers by this authorMarcel Hayat MD, Marcel Hayat MD Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceSearch for more papers by this author Mohamed B. Azab MD, MSc, Corresponding Author Mohamed B. Azab MD, MSc Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceDepartment of Medicine A, Institut Gustave-Roussy, Rue Camille Desmoulins, 94805 Villejuif Cedex France===Search for more papers by this authorMichel Henry-Amar MD, Michel Henry-Amar MD Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceSearch for more papers by this authorPhilippe Rougier MD, Philippe Rougier MD Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceSearch for more papers by this authorCaroline Bognel MD, Caroline Bognel MD Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceSearch for more papers by this authorChristine Theodore MD, Christine Theodore MD Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceSearch for more papers by this authorPatrice Carde MD, Patrice Carde MD Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceSearch for more papers by this authorPhilippe Lasser MD, Philippe Lasser MD Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceSearch for more papers by this authorJean-Marc Cosset MD, Jean-Marc Cosset MD Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceSearch for more papers by this authorBernard Caillou MD, Bernard Caillou MD Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceSearch for more papers by this authorJean-Pierre Droz MD, Jean-Pierre Droz MD Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceSearch for more papers by this authorMarcel Hayat MD, Marcel Hayat MD Departments of Medical Oncology, Medical Statistics, Gastroenterologic Oncology, Histopathology, Surgical Oncology, and Radiotherapy, Institut Gustave-Roussy, Villejuif, FranceSearch for more papers by this author First published: 15 September 1989 https://doi.org/10.1002/1097-0142(19890915)64:6<1208::AID-CNCR2820640608>3.0.CO;2-ZCitations: 104AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat Abstract The authors have reviewed 106 cases of primary gastrointestinal non-Hodgkin's lymphoma (GI-NHL) treated at the Institut Gustave-Roussy (IGR), France, between 1975 and 1986. The occurrence was 55 in the stomach, 26 in the small intestine, ten ileocecal, seven in the large intestine, and eight patients had multiple involvement. Patients were clinically staged according to the Ann Arbor staging system using the modification of Musshoff for Stage IIE. All histologic material of the 106 patients were reviewed and graded according to the Working Formulation (WF) and the Kiel classifications. Most patients received combination chemotherapy as part or all of their primary treatment program (95 patients, 90%). Seventy five patients (71%) had a multimodality treatment. The overall 5-year survival rate was 60%. Sixteen variables were tested by univariate analyses for prognostic influence on survival. Of these, only clinical stage (P < 0.001), the achievement of initial complete remission (CR) (P < 0.001), erythrocyte sedimentation rate (ESR) (P = 0.01), mesenteric involvement (P = 0.03), and serosal infiltration (P = 0.05) were significant prognostic factors. Important variables were tested by a multivariate analysis using the Cox model taking into account different treatment modalities. Only three variables entered the regression analysis at a significant level: clinical stage (P = 0.02), surgical resection (P = 0.03), and histologic grade (Kiel) (P = 0.04). When the achievement of initial CR was introduced into the model, it was the most significant variable (P < 0.001) whereas all other variables became nonsignificant except for the histologic grade (Kiel) (P = 0.004). 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