title: Primary gastric non-Hodgkin's lymphoma in Chinese patients: clinical characteristics and prognostic factors.
abstract: BACKGROUND
  Optimal management and outcome of primary gastric lymphoma (PGL) have not been well defined in the rituximab era. This study aimed to analyze the clinical characteristics, prognostic factors, and roles of different treatment modalities in Chinese patients with PGL.
  
  
  METHODS
  The clinicopathological features of 83 Chinese patients with PGL were retrospectively reviewed. Staging was performed according to the Lugano staging system for gastrointestinal non-Hodgkin's lymphoma.
  
  
  RESULTS
  The predominant pathologic subtype among Chinese patients with PGL in our study was diffuse large B cell lymphoma (DLBCL), followed by mucosa-associated lymphoid tissue (MALT) lymphoma. Among the 57 patients with gastric DLBCL, 20 patients (35.1%) were classified as the germinal center B cell-like (GCB) subtype and 37 patients (64.9%) as the non-GCB subtype. The 83 patients had a five-year overall survival (OS) and event-free survival (EFS) of 52% and 59%, respectively. Cox regression analysis showed that stage-modified international prognostic index (IPI) and performance status (PS) were independent predictors of survival. In the 67 B-cell lymphoma patients who received chemotherapy, 36 patients treated with rituximab (at least 3 cycles) had a mean OS of 72 months (95% CI 62-81) versus 62 months (95% CI 47-76) for patients without rituximab treatment (P = 0.021).
  
  
  CONCLUSIONS
  The proportion of Chinese gastric DLBCL cases with non-GCB subtype was higher than the GCB subtype. Stage-modified IPI and PS were effective prognostic factors in Chinese patients with PGL. Our data suggested that primary gastric B-cell lymphoma might have an improved outcome with rituximab in addition to chemotherapy. More studies are necessary, preferentially large prospective randomized clinical trials to obtain more information on the impact of the rituximab in the primary gastric B-cell lymphoma.
authors.affiliation: State Key Laboratory of Oncology in Southern China, Sun Yat-sen University, Guangzhou, Guangdong, China.
authors.forename: Jiajia
authors.initials: J
authors.lastname: Huang
authors.forename: WenQi
authors.initials: W
authors.lastname: Jiang
authors.forename: Ruihua
authors.initials: R
authors.lastname: Xu
authors.forename: HuiQiang
authors.initials: H
authors.lastname: Huang
authors.forename: Yue
authors.initials: Y
authors.lastname: Lv
authors.forename: ZhongJun
authors.initials: Z
authors.lastname: Xia
authors.forename: XiaoFei
authors.initials: X
authors.lastname: Sun
authors.forename: ZhongZhen
authors.initials: Z
authors.lastname: Guan
authors.forename: Tongyu
authors.initials: T
authors.lastname: Lin
authors.forename: ZhiMing
authors.initials: Z
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005743:Gastrectomy; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000473:pathology* / Q000628:therapy*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology* / Q000628:therapy*; D015996:Survival Rate; D055815:Young Adult