title: Increased risk of gastric adenocarcinoma after treatment of primary gastric diffuse large B-cell lymphoma.
abstract: BACKGROUND
  There have been sporadic reports about synchronous as well as metachronous gastric adenocarcinoma and primary gastric lymphoma. Many reports have dealt with metachronous gastric adenocarcinoma in mucosa-associated lymphoid tissue lymphoma of stomach. But to our knowledge, there have been no reports that document the increased incidence of metachronous gastric adenocarcinoma in patients with gastric diffuse large B-cell lymphoma. This retrospective study was conducted to estimate the incidence of metachronous gastric adenocarcinoma after primary gastric lymphoma treatment, especially in diffuse large B-cell lymphoma.
  
  
  METHODS
  The retrospective cohort study of 139 primary gastric lymphoma patients treated with radiotherapy at our hospital. Mean observation period was 61.5 months (range: 3.7-124.6 months). Patients profile, characteristics of primary gastric lymphoma and metachronous gastric adenocarcinoma were retrieved from medical records. The risk of metachronous gastric adenocarcinoma was compared with the risk of gastric adenocarcinoma in Japanese population.
  
  
  RESULTS
  There were 10 (7.2%) metachronous gastric adenocarcinoma patients after treatment of primary gastric lymphomas. It was quite high risk compared with the risk of gastric carcinoma in Japanese population of 54.7/100,000. Seven patients of 10 were diffuse large B-cell lymphoma and other 3 patients were mixed type of diffuse large B-cell lymphoma and mucosa associated lymphoid tissue lymphoma. Four patients of 10 metachronous gastric adenocarcinomas were signet-ring cell carcinoma and two patients died of gastric adenocarcinoma. Metachronous gastric adenocarcinoma may have a more malignant potential than sporadic gastric adenocarcinoma. Old age, Helicobacter pylori infection and gastric mucosal change of chronic gastritis and intestinal metaplasia were possible risk factors for metachronous gastric adenocarcinoma.
  
  
  CONCLUSIONS
  There was an increased risk of gastric adenocarcinoma after treatment of primary gastric lymphoma, especially of diffuse large B-cell lymphoma.
authors.affiliation: Department of Radiation Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. koinaba@ncc.go.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Inaba
authors.forename: Ryoji
authors.initials: R
authors.lastname: Kushima
authors.forename: Naoya
authors.initials: N
authors.lastname: Murakami
authors.forename: Yuuki
authors.initials: Y
authors.lastname: Kuroda
authors.forename: Ken
authors.initials: K
authors.lastname: Harada
authors.forename: Mayuka
authors.initials: M
authors.lastname: Kitaguchi
authors.forename: Kotaro
authors.initials: K
authors.lastname: Yoshio
authors.forename: Shuhei
authors.initials: S
authors.lastname: Sekii
authors.forename: Kana
authors.initials: K
authors.lastname: Takahashi
authors.forename: Madoka
authors.initials: M
authors.lastname: Morota
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mayahara
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ito
authors.forename: Minako
authors.initials: M
authors.lastname: Sumi
authors.forename: Takashi
authors.initials: T
authors.lastname: Uno
authors.forename: Jun
authors.initials: J
authors.lastname: Itami
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D015994:Incidence; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D012306:Risk; D013274:Stomach Neoplasms / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult