title: Retrospective comparison of the effectiveness of various treatment modalities of extragastric MALT lymphoma: a single-center analysis.
abstract: We have performed a retrospective analysis of all patients with extragastric mucosa-associated lymphoid tissue (MALT) lymphoma treated at our institution to compare the efficacy of first-line therapeutic modalities including surgery, radiation, systemic therapy, and antibiotics. One hundred eighty-five patients with extragastric MALT lymphoma with a median age of 63 (interquartile range (IQR) 50-74) years and a median follow-up time of 49 (IQR 18-103) months were retrospectively analyzed. Time to progression and time to next therapy were used as surrogate endpoints for efficacy. Patients having either surgery (100 %), chemo/immunotherapy (85.5 %), or radiation (80 %) had significantly (p = 0.01) higher response rates than patients treated with antibiotics (33.3 %). Patients who were irradiated had significantly more progressive disease, but also the longest follow-up time. Stage, elevated LDH, anemia, elevated beta-2 microglobulin, plasmacytic differentiation, monoclonal gammopathy, or autoimmune disease did not influence the rate of disease progression nor did complete remission or partial remission from initial therapy influence time to and rate of progression. There was no significant difference in the median time to progression (p = 0.141), but the estimated time to progression (p = 0.023) as well as the estimated time to next therapy (p = 0.021) was significantly different among the various cohorts favoring surgery, chemo/immunotherapy, and radiation. Our results suggest extragastric MALT lymphoma as a potential systemic disease irrespective of initial stage. Radiation, surgery, and chemo/immunotherapy seem to be equally effective in achieving remissions and prolonged progression free survivals, but a curative potential is questionable. Localized MALT lymphomas affecting the thyroid gland or the lungs have excellent long-term progression-free survivals with surgical treatment only.
authors.affiliation: Division of Bone Marrow Transplantation, Department of Internal Medicine 1, Medical University of Vienna, Vienna, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Wöhrer
authors.forename: Barbara
authors.initials: B
authors.lastname: Kiesewetter
authors.forename: Julia
authors.initials: J
authors.lastname: Fischbach
authors.forename: Leonhard
authors.initials: L
authors.lastname: Müllauer
authors.forename: Marlene
authors.initials: M
authors.lastname: Troch
authors.forename: Julius
authors.initials: J
authors.lastname: Lukas
authors.forename: Marius E
authors.initials: ME
authors.lastname: Mayerhoefer
authors.forename: Markus
authors.initials: M
authors.lastname: Raderer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001317:Austria / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000097:blood / Q000401:mortality / Q000628:therapy; D003131:Combined Modality Therapy; D018450:Disease Progression; D018572:Disease-Free Survival; D005134:Eye Neoplasms / Q000097:blood / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy; D006801:Humans; D007167:Immunotherapy; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000097:blood / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy; D018442:Lymphoma, B-Cell, Marginal Zone / Q000097:blood / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D009928:Organ Specificity; D012189:Retrospective Studies; D012468:Salivary Gland Neoplasms / Q000097:blood / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy; D013964:Thyroid Neoplasms / Q000097:blood / Q000401:mortality / Q000601:surgery / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents