All of the following are indications for surgery in gastric lymphoma Except (not dermatology question)

Treatment of gastric lymphoma SURGERY FOR EARLY STAGE GASTRIC LYMPHOMA: The recommended treatment of stage I disease was surgery alone in 30% of studies, surgery and radiation therapy in 32%, surgery and chemotherapy in 15%, and surgery, chemotherapy, and radiation therapy in 8%. Only 20% of studies recommended treatment without surgery a. 1st line (for all stage): Radiotherapy + chemotherapy b. Surgery is reserved only for urgent cases (bleeding, perforation) in which gastrectomy is done, followed by chemotherapy c. Surgical resection is also carried out for patients who respond to chemotherapy but have residual disease. Ref Harrison 20th edition pg 1345