Long-term treatment of localized gastric marginal zone B-cell mucosa associated lymphoid tissue lymphoma including incidence of metachronous gastric cancer

J Gastroenterol Hepatol. 2010 Apr;25(4):804-9. doi: 10.1111/j.1440-1746.2009.06204.x.

Abstract

Background and aim: According to a few recent reports on the long-term clinical outcome of gastric marginal zone B-cell mucosa associated lymphoid tissue lymphoma (MALT lymphoma); localized gastric MALT lymphoma generally has a favorable prognosis. However, the risk of metachronous gastric cancer has not been evaluated. In this study, we analyzed long-term outcomes of localized gastric MALT lymphoma including the incidence of metachronous gastric cancer.

Methods: Between April 1996 and May 2008, 60 patients (31 men and 29 women; mean age 58.1 years) with localized gastric MALT lymphoma (stage I and II(1) according to Lugano classification) were analyzed retrospectively.

Results: Forty-eight patients (82.6%) achieved complete remission by eradication therapy. Radiation therapy was conducted on eight patients as second-line treatment, and all of them achieved remission. The median follow-up period was 76 months (range, 12-157 months). One patient had local relapse after remission for 5 years and three patients developed early gastric cancer without recurrence of lymphoma (5%). All of the three gastric cancers appeared in the same areas where MALT lymphoma had been eradicated.

Conclusion: Eradication therapy and radiation therapy for localized gastric MALT lymphoma have a favorable long-term outcome, though regular follow-up endoscopy should be performed for detecting metachronous early gastric cancer.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Biopsy
  • Chemotherapy, Adjuvant
  • Disease-Free Survival
  • Endoscopy, Gastrointestinal
  • Female
  • Gastrectomy*
  • Humans
  • Incidence
  • Japan / epidemiology
  • Kaplan-Meier Estimate
  • Lymphoma, B-Cell, Marginal Zone / epidemiology
  • Lymphoma, B-Cell, Marginal Zone / pathology
  • Lymphoma, B-Cell, Marginal Zone / therapy*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / therapy
  • Neoplasm Staging
  • Neoplasms, Second Primary / epidemiology*
  • Neoplasms, Second Primary / pathology
  • Neoplasms, Second Primary / therapy
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Stomach Neoplasms / epidemiology
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / therapy*
  • Time Factors
  • Treatment Outcome