title: Second cancers and residual disease in patients treated for gastric mucosa-associated lymphoid tissue lymphoma by Helicobacter pylori eradication and followed for 10 years.
abstract: OBJECTIVE
  Cure of Helicobacter pylori infection induces remission in most patients with gastric mucosa-associated lymphoid tissue lymphoma (GML) that is associated with these bacteria. We determined the long-term outcomes of these patients in a prospective multicenter trial and investigated whether they developed second cancers or had histologic residual disease.
  
  
  METHODS
  We followed 120 patients with stage EI1 GML for a median of 122 months after H pylori eradication (range, 1-171 months). Remission was determined by histology analysis and development of second cancers was documented.
  
  
  RESULTS
  Of the patients, 80% (96 of 120) achieved complete remission from GML, and 80% of those (77 of 96) remained disease free. Estimated mean survival time in the Kaplan-Meier analysis was 147 months (95% confidence interval: 138-156 months). Of the patients that achieved complete remission, 17% (16 of 96) had histologic residual disease after a median of 32 months (range, 3-68 months). Disease did not progress in any of these patients, and all but 1 achieved a second complete remission (median duration, 46 months). Standardized morbidity ratios revealed a significantly higher incidence of gastric cancer (8.567; 95% confidence interval, 3.566-20.582) or non-Hodgkin lymphoma (18.621; 95% confidence interval: 8.365-41.448) in the 96 patients that achieved a complete remission, compared with the general German population.
  
  
  CONCLUSIONS
  Cure of H pylori infection leads to continuous complete remission in most patients with H pylori-associated GML. Patients are at risk for development of secondary cancers (ie, gastric cancer and non-Hodgkin lymphoma).
authors: Universitätstumorzentrum, Heinrich-Heine-Universität, Düsseldorf, Germany. thomas.wuendisch@med.uni-duesseldorf.de
authors: Thomas
authors: T
authors: Wündisch
authors: Philipp
authors: P
authors: Dieckhoff
authors: Brandon
authors: B
authors: Greene
authors: Christian
authors: C
authors: Thiede
authors: Christian
authors: C
authors: Wilhelm
authors: Manfred
authors: M
authors: Stolte
authors: Andreas
authors: A
authors: Neubauer
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002277:Carcinoma / Q000175:diagnosis*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology*; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D053208:Kaplan-Meier Estimate; D018442:Lymphoma, B-Cell, Marginal Zone / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D016609:Neoplasms, Second Primary / Q000175:diagnosis*; D012074:Remission Induction; D013274:Stomach Neoplasms / Q000175:diagnosis*; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents