Long-term treatment of localized gastric marginal zone B-cell mucosa associated lymphoid tissue lymphoma including incidence of metachronous gastric cancer.
OBJECTIVE
According to a few recent reports on the long-term clinical outcome of gastric marginal zone B-cell mucosa associated lymphoid tissue lymphoma (MALT lymphoma); localized gastric MALT lymphoma generally has a favorable prognosis. However, the risk of metachronous gastric cancer has not been evaluated. In this study, we analyzed long-term outcomes of localized gastric MALT lymphoma including the incidence of metachronous gastric cancer.


METHODS
Between April 1996 and May 2008, 60 patients (31 men and 29 women; mean age 58.1 years) with localized gastric MALT lymphoma (stage I and II(1) according to Lugano classification) were analyzed retrospectively.


RESULTS
Forty-eight patients (82.6%) achieved complete remission by eradication therapy. Radiation therapy was conducted on eight patients as second-line treatment, and all of them achieved remission. The median follow-up period was 76 months (range, 12-157 months). One patient had local relapse after remission for 5 years and three patients developed early gastric cancer without recurrence of lymphoma (5%). All of the three gastric cancers appeared in the same areas where MALT lymphoma had been eradicated.


CONCLUSIONS
Eradication therapy and radiation therapy for localized gastric MALT lymphoma have a favorable long-term outcome, though regular follow-up endoscopy should be performed for detecting metachronous early gastric cancer.
Ono
Shouko
S
Division of Endoscopy, Hokkaido University Hospital, Sapporo, Japan. onosho@med.hokudai.ac.jp
Kato
Mototsugu
M
Takagi
Kikuko
K
Kodaira
Junichi
J
Kubota
Kanako
K
Matsuno
Yoshihiro
Y
Komatsu
Yoshito
Y
Asaka
Masahiro
M
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001706:Biopsy; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005743:Gastrectomy; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D018442:Lymphoma, B-Cell, Marginal Zone / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome