Indication of surgery in gastric lymphoma are all except:
Correct Answer: Intractable pain
Description: Ans: D (Intractable..) /Ref Love & Bailey 25th/ 1075; Sabiston 18th/1270-71: Oxford Surgery 5th/174]"First-line therapy for low-grade MALT lymphomas is use of antibiotics directed at H. pylori eradication, which leads to complete remission rates of 70% to 100%. Chemoradiation therapy is used as salvage therapy for failure of antibiotics. High-grade or non-MALT lymphomas are generally treated with chemoradiation therapy alone, with surgical resection reserved for those who /b/7 chemoradiation or in emergency cases of hemorrahage or perforationOxford Surgery 5th/l 74"For gastric lymphoma limited to the stomach and regional nodes, radical subtotal gastrectomy may be performed, especially for bulky tumors with bleeding and/or obstruction. Palliative gastrectomy for tumor complications also has a role. Recently, patients have been treated with primary chemotherapy and radiation without operation, and the results have been quite good. Perforation and bleeding especially from thick tumors, is a recognized complication of this approach. Certainly, a multidisciplinary team should be involved with the treatment plan for patients with primary gastric lymphoma" Sabiston 18th/ 1270
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