title: Evaluation of the clinical characteristics, management, and prognosis of 103 patients with gastric mucosa-associated lymphoid tissue lymphoma.
abstract: The diagnosis of gastric mucosa-associated lymphoid tissue (MALT) lymphoma is difficult owing to its non-specific symptoms and various endoscopic findings. Treatments such as radiotherapy (RT) for localized and chemotherapy (CT) for advanced stages of the disease are employed. The aim of the present study was to examine the clinical characteristics and prognostic factors ofHelicobacter pylori(H. pylori) eradication (HPE) in patients with gastric MALT lymphoma. The medical records of 103 patients with gastric MALT lymphoma for the period 2001-2013, were analyzed. The 103 median age of the patients was 53 years and the male to female ratio was 1:1. Serum lactate dehydrogenase and β2-microglobulin were within normal range. Macroscopically, the most commonly involved site was the antrum, followed by the corpus and fundus. A total of 97 patients (94%) tested positive forH. pylori. Forty patients (39%) had stage I, 35 patients (35%) had local or distant nodal involvement, 20 of 103 patients had stage IIIE (19%) and 8 of 103 patients had stage IV (7%) disease. Complete remission, after HPE, was achieved in 54 of the 69 patients (78%) that wereH. pylori-positive and in 2 of the 4 patients (50%) that wereH. pylori-negative. HPE had a superior trend in theH. pylori-positive patients although no significant difference was identified in the two groups (p=0.194). In patients with advanced disease, the 5-year progression-free survival (PFS) and overall survival (OS) estimates were significantly improoved for patients receiving HPE with CT or RT than those receiving CT or RT (p=0.046 and 0.035, respectively). The multivariate analysis revealed that, the advanced stages were independently associated with shorter PFS, and the modified-International Prognostic Index (m-IPI) (≥2) was associated with shorter OS. In conclusion, gastric MALT lymphoma had a favorable outcome with a high OS rate. HPE was an effective treatment for gastric MALT lymphoma. The patients with advanced stages and m-IPI (≥2) had a much worse prognosis.
authors.affiliation: Department of Medical Oncology, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, P.R. China.
authors.forename: Xiaowu
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Medical Oncology, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, P.R. China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Pathology, Tianjin Cancer Institute and Hospital, Tianjin 300060, P.R. China.
authors.forename: Zhongli
authors.initials: Z
authors.lastname: Zhan
authors.affiliation: Department of Pathology, Tianjin Cancer Institute and Hospital, Tianjin 300060, P.R. China.
authors.forename: Lianyu
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Pathology, Tianjin Cancer Institute and Hospital, Tianjin 300060, P.R. China.
authors.forename: Baochun
authors.initials: B
authors.lastname: Sun
authors.affiliation: Department of Hematology, Tianjin Cancer Institute and Hospital, Tianjin 300060, P.R. China.
authors.forename: Yizhuo
authors.initials: Y
authors.lastname: Zhang
keywords: Helicobacter pylori eradication; gastric mucosa-associated lymphoid tissue; prognosis; treatment