Prognostic factors in malignant lymphoreticular tumors of the small bowel and ileocecal region: A review of 50 case histories

Malignant lymphoreticular tumors (MLT) of the small bowel and ileocecal region constitute a quarter of all MLT in children, but are much less frequent in adults. Lesions that occur in young people are mostly ileocecal, and are undifferentiated cytologically. Older patients have a more even distribution along the small bowel and the tumors are predominantly histiocytic. There are no differences in survival between younger and older patients, but the young have a higher proportion of localized tumors (Stage I). The site of presentation along the bowel has no prognostic significance. Para-aortic node involvement has no greater significance than regional mesenteric spread. It is important to add large field or whole abdominal irradiation to the most complete resection possible. Chemotherapy plays a role in patients with Stages III and IV disease, but there is not sufficient benefit to recommend cytotoxic drugs as adjuvants in more limited disease. Patients who are alive and well 15 months or more after treatment remain free of disease.