Primary gastric lymphoma: a 15-year review.

BACKGROUND/AIM: Between 1976 and 1991, 25 patients underwent surgical therapy for primary gastric lymphoma. Clinical records were reviewed retrospectively to evaluate prognostic factors and impact of treatment on survival. RESULTS: Diagnostic sensitivity of endoscopic biopsy was 68%, positively of barium contrast studies for tumor was 33%. The overall 5-year survival rate was 67.3% (51.7% "free disease"): it was for stage I E 88.9%, for stages II 1E and II 2E respectively 68.6% and 44.4% and for stage IV 33.4%. Patients with tumors smaller than 5 cm had a 5-year survival rate of 80.8% whereas for patients with larger lesions survival rate was 44% (p < 0.05). Patients with low grade malignancy tumors had a 5-year survival rate of 81.9% versus 37.5% for high grade malignancy tumors (p < 0.03). Chemotherapy as adjuvant therapy was used in 17 cases (68%). 53% of them are "free disease" at minimum 4 years from the operation. CONCLUSIONS: We conclude that, surgical management of primary gastric lymphoma is mandatory but a planned multimodality therapy may produce complete remission and long-term "free disease" survival rate even in patients with relapse.

Imipenem/cilastatin (1.5 g daily) versus meropenem (3.0 g daily) in patients with intra-abdominal infections: results of a prospective, randomized, multicentre trial.

An open-label prospective, randomized, parallel multicentre study was undertaken to compare the efficacy and tolerability of 1.5 g/day intravenous imipenem/cilastatin with 3 g/day intravenous meropenem in the treatment of intra-abdominal infections. A total of 287 patients were enrolled: 201 patients, divided between the 2 treatment groups, were evaluable. Clinical outcome, bacteriological outcome, untoward microbiological effects, and clinical and laboratory adverse experiences were evaluated. 98% of patients receiving imipenem/cilastatin therapy were cured, with 96% showing eradication of infection. 95% of those on meropenem were cured, with 98% showing eradication. These differences in clinical and bacteriological outcome between the 2 treatments were not statistically significant. Two patients receiving imipenem/cilastatin and 5 receiving meropenem had untoward microbiological effects. There was a 0.7% frequency (1/139 patients) of possibly or probably drug-related clinical or laboratory adverse experiences with imipenem/cilastatin and a 2.7% frequency (4/148) with meropenem. The mean time to defervescence was significantly less for patients in the imipenem/cilastatin treatment group than for those receiving meropenem. This study shows that 1.5 g/day of imipenem/cilastatin is equivalent to 3.0 g/day meropenem in clinical and bacteriological outcome, as well as in incidence of side effects.