Primary non-Hodgkin lymphoma of the large bowel.

Abstract

To characterize the natural history of primary non-Hodgkin lymphoma of the large bowel and identify prognostic factors. Twenty-three patients with primary non-Hodgkin lymphoma according to strict criteria were identified. Seventeen patients underwent resection, and six patients underwent biopsy. Among 19 patients with intermediate- or high-grade lymphoma, 13 had diffuse large cell lymphoma. Ann Arbor stage was I in 15 cases, II in seven cases, and IV in one case. In 15 patients, the International Prognostic Index was available: 0, eight patients; 1, six patients; and 3, one patient. Postoperatively, six patients received combined chemotherapy and radiation therapy, eight patients received chemotherapy, and six patients received radiation therapy. Overall and relapse-free survival were calculated actuarially, and univariate analysis was performed with regard to stage, treatment, extent of surgery, and the International Prognostic Index. Median follow-up was 144 months. Two patients' disease recurred. Overall and relapse-free survival at 10 years were 61% and 82%, respectively. The International Prognostic Index was the only significant prognostic factor for overall survival (P = .03, log-rank test). The prognosis of primary non-Hodgkin lymphoma appears to be as good as that of low- or intermediate-grade lymphoma. The only significant prognostic factor for overall survival is the International Prognostic Index.