78 High Adenocarcinoma Risk After Diagnosis of Gastric MALT Lymphoma: A Long-Term Nationwide Study

Primary gastric lymphoma (PGL) represents a rare pathology, which can be easily misdiagnosed because of unspecific symptoms of the digestive tract. Histologically, PGL can vary from indolent marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) to aggressive diffuse large B-cell lymphoma (DLBCL). During the years, clinical trials revealed the important role of Helicobacter pylori (H. pylori) in the pathogenesis of gastric MALT lymphoma. Infection with Helicobacter pylori is an influential promoter of gastric lymphomagenesis initiation. Long-term studies revealed that eradication therapy could regress gastric lymphomas.

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Long-Term Clinical Outcomes of Gastric MALT Lymphoma: A Nationwide Multicenter Study in Korea

Frontiers in Oncology ◽

10.3389/fonc.2021.681689 ◽

2021 ◽

Vol 11 ◽

Author(s):

Joon Sung Kim ◽

Jun Chul Park ◽

Jong Yeul Lee ◽

Ji Yong Ahn ◽

Sun Hyung Kang ◽

...

Keyword(s):

Overall Survival ◽

Malt Lymphoma ◽

Case Series ◽

Stage Iii ◽

Gastric Malt Lymphoma ◽

University Hospitals ◽

Initial Stage ◽

Testing Stage ◽

H Pylori

BackgroundTreatment recommendations for gastric mucosa-associated lymphoid tissue (MALT) lymphoma are based on case series and expert opinions. Only a few previous studies have focused on the long-term outcomes of gastric MALT lymphoma, especially according to stage.MethodsPatients diagnosed with gastric MALT lymphoma from January 2000 to December 2018 at nine university hospitals in Korea were included. Clinical data of medical history, endoscopic features, histological diagnosis, results of Helicobacter pylori (H. pylori) testing, stage, treatment conditions, and outcomes were collected.ResultsA total of 1,163 patients was enrolled, and 97.6% (n=1,038) of patients were diagnosed as stage IE. 10-year overall survival (OS) for the entire population was 99.1% and was better for patients in stage IE compared with patients in stage III/IV (p=0.002). The 10-year OS for H. pylori-positive patients was better than that of H. pylori-negative patients (p=0.022). Multivariate analyses revealed initial stage III/IV as a prognostic factor associated with over-all survival.ConclusionThe majority of gastric MALT lymphoma patients are diagnosed at an early localized stage in Korea. The overall survival rate of gastric MALT lymphoma is excellent and is associated with the initial stage of the disease.

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Long-term follow-up of patients with low-grade gastric MALT lymphoma after eradication of helicobacter pylori

Gastroenterology ◽

10.1016/s0016-5085(00)85192-6 ◽

2000 ◽

Vol 118 (4) ◽

pp. A764

Author(s):

In Sung Song ◽

You Sun Kim ◽

Il Ju Choi ◽

Joo Sung Kim ◽

Hyun Chae Jung ◽

...

Keyword(s):

Helicobacter Pylori ◽

Malt Lymphoma ◽

Gastric Malt Lymphoma ◽

Low Grade ◽

Long Term Follow Up

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Management and Long-Term Clinical Outcome of Api2-Malt1 Positive Gastric Malt Lymphoma

Annals of Oncology ◽

10.1093/annonc/mdu339.23 ◽

2014 ◽

Vol 25 ◽

pp. iv333

Author(s):

M. Tajika ◽

Y. Niwa ◽

T. Tanaka ◽

M. Ishihara ◽

N. Mizuno ◽

...

Keyword(s):

Clinical Outcome ◽

Malt Lymphoma ◽

Gastric Malt Lymphoma

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Long-Term Clinical Outcome of Gastric MALT Lymphoma After Eradication of Helicobacter pylori : A Multicenter Retrospective Follow-up Study of 423 Patients in Japan

Gastroenterology ◽

10.1016/s0016-5085(11)63624-x ◽

2011 ◽

Vol 140 (5) ◽

pp. S-872

Author(s):

Shotaro Nakamura ◽

Katsunori Iijima ◽

Shouko Ono ◽

Masahiro Tajika ◽

Akira Tari ◽

...

Keyword(s):

Helicobacter Pylori ◽

Clinical Outcome ◽

Malt Lymphoma ◽

Gastric Malt Lymphoma ◽

Follow Up Study

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Relapse of Low-Grade Gastric MALT Lymphoma After Helicobacter Pylori Eradication: True Relapse or Persistence? Long-Term Post-Treatment Follow-Up of a Multicenter Trial in the North-East of Italy and Evaluation of the Diagnostic Protocol’s Adequacy

Gastrointestinal Lymphoma - Recent Results in Cancer Research ◽

10.1007/978-3-642-57054-4_15 ◽

2000 ◽

pp. 116-124 ◽

Cited By ~ 42

Author(s):

A. Savio ◽

M. Valli ◽

G. Zamboni ◽

P. Capelli ◽

A. Scarpa ◽

...

Keyword(s):

Helicobacter Pylori ◽

Malt Lymphoma ◽

Multicenter Trial ◽

Gastric Malt Lymphoma ◽

Low Grade ◽

Helicobacter Pylori Eradication ◽

North East ◽

The North

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Long Term Outcome of Gastric MALT Lymphoma Patients Treated with Anti-Helicobacter (Antibiotic and Proton-Pump Inhibitor) Regimens.

Blood ◽

10.1182/blood.v110.11.2583.2583 ◽

2007 ◽

Vol 110 (11) ◽

pp. 2583-2583 ◽

Cited By ~ 2

Author(s):

Claudio Chini ◽

Graziella Pinotti ◽

Anastasios Stathis ◽

Ilaria Proserpio ◽

Francesco Bertoni ◽

...

Keyword(s):

Malt Lymphoma ◽

Proton Pump ◽

Initial Treatment ◽

Eradication Therapy ◽

Gastric Malt Lymphoma ◽

Term Outcome ◽

Long Term Outcome ◽

Histological Score

Abstract Background: Primary mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach is often associated with Helicobacter pylori (Hp) infection and Hp eradication therapy is widely accepted as initial treatment. The aim of this study is to report the clinical characteristics and long term outcome in a large series of patients with gastric MALT lymphoma exclusively treated with Hp eradication therapy. Methods: 105 newly diagnosed gastric MALT lymphoma patients (54 men and 51 women) with median age of 64 years (range 20–94) referred to our institutions between June 1990 and November 2006 were eligible for the study. Staging was performed according to the Lugano staging system. All patients received anti-Hp eradication therapy as initial treatment with standard regimens combining antibiotics (usually Amoxicillin, Clarithromycin and/or Metronidazole) and proton-pump inhibitors (Omeprazole in most cases). Responses, evaluated with regular endoscopic biopsies every 3–6 months were graded according to the Wotherspoon’s histological score system. Results: 100 patients had stage I and 5 patients had stage IIE1 disease. Hp was positive in 83 patients (79.5%) and was eradicated in all positive patients but 19 patients required a second line antibiotic therapy. Symptoms disappeared or markedly diminished and endoscopic features improved in almost all patients after Hp eradication. Histological regression of the gastric lymphoma was achieved in 78 of 102 evaluable patients (76%, 95% C.I.; 67%–84%) with histological complete response (Wotherspoon’s score 0–2) in 66 and partial response (score 3) in 12 patients. Of the 78 patients who achieved a lymphoma regression, the histological remission was consistently confirmed at follow-up endoscopies in 28 patients (36%), while 33 (42%) had histological score fluctuations (from 0–4), sometimes with transient histological relapses followed by spontaneous histological remissions. Ten patients had a frank lymphoma relapse (2 with high-grade transformation) and 7 died in remission for other causes. At a median follow up time of 6.3 years, the overall survival in the entire group is 92% at 5 years (95% C.I.; 84%–96%), 83% at 10 years (95% C.I.; 70%–91%) and 78% at 15 years (95% C.I.; 62%–88%). Only one patient died for lymphoma (after histological transformation). Additional tumors were observed in 22%. A history of autoimmune disease was present in 15% of the patients and did not affect the outcome. Conclusions: Hp eradication usually results in long term disease control, independently of the lymphoma pathological remission status. A watch and wait policy seems safe in patients with local histological relapse with no endoscopic evidence of gross disease.

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