Primary Pulmonary MALT Lymphoma: Clinical Characteristics and Treatment Outcomes – Single Institution Experience

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4168-4168
Author(s):  
Grzegorz S. Nowakowski ◽  
Kay Ristow ◽  
Paul Kurtin ◽  
Mark S Allen ◽  
Ivana N Micallef ◽  
...  
Keyword(s):  
Overall Survival ◽  
Treatment Outcomes ◽  
Malt Lymphoma ◽  
Mayo Clinic ◽  
Pulmonary Lesion ◽  
Treatment Modalities ◽  
Gastric Malt Lymphoma ◽  
Single Institution ◽  
Pulmonary Malt Lymphoma ◽  
The Impact

Abstract Abstract 4168 Background: Primary Pulmonary MALT lymphoma represents 15–20% of Extranodal Marginal Zone Lymphomas of Mucosa Associated Lymphoid Tissue (MALT). In contrast to the more common gastric MALT lymphoma, natural history, prognosis and treatment outcomes for primary pulmonary MALT lymphoma are not well defined. Herein, we report a single institution experience. Methods: Consecutive patients with primary pulmonary MALT lymphoma registered in the Mayo Clinic Lymphoma Database, which includes all consenting patients with lymphoma seen at Mayo Clinic Rochester, were reviewed for clinical features, treatment outcome progression free survival (PFS) and overall survival (OS). The pathology for all patients was centrally reviewed by hematopathologist and the diagnoses were based on WHO lymphoma classification criteria. PFS and OS were assessed using the Kaplan–Meier method and the Cox proportional hazard model was used to assess the impact of variables on PFS and OS. Results: Between December 1986 and June of 2009, ninety-seven patients with primary pulmonary MALT lymphoma were enrolled. The median age at diagnosis was 63 years (range 31–87). There were 43 (44%) males. The initial presentation was a unilateral pulmonary lesion (n=47, 48%), bilateral pulmonary lesions (n=41, 42%), and pulmonary lesion with intrathoracic lymphadenopathy (n= 4, 4%). Bone marrow involvement and presence of B symptoms were 4, 4% and 5, 5%, respectively. International Prognostic Index (IPI) was 0–1, 2–3 and 4–5 in 69, 25 and 1 patient(s) respectively. The median follow-up was 10.4 years. The estimated median OS was 13. 6 years and the median PFS was 5.5 years (Figure). In a multivariate analysis, age >60 (p=0.02) and ECOG PS>2 (p=0.01) were associated with shortened survival. The IPI and age adjusted IPI were not predictive of overall survival. The treatment outcomes for the most common treatment modalities are summarized in the Table below. The median PFS of the 38% of patients who had a complete surgical resection was excellent at 11.2 years; whereas for observed patients with residual disease after biopsy was 3.2 years. Only 8 patients received single agent rituximan with relatively low response rate. Summary: The prognosis of primary pulmonary MALT lymphoma is favorable, with a median survival of over 13 years. In patients with resectable disease, surgery alone is associated with excellent disease control. Further prospective studies are needed to define the optimal treatment of primary pulmonary MALT lymphoma. Disclosures: No relevant conflicts of interest to declare.

Primary Parotid MALT Lymphoma: Clinical Characteristics and Treatment – a Single Institution Experience

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1580-1580
Author(s):  
Jason M. Jones ◽  
Thomas M. Habermann ◽  
Kay M. Ristow ◽  
Paul Kurtin ◽  
Ellen McPhail ◽  
...  
Keyword(s):  
Overall Survival ◽  
Malt Lymphoma ◽  
Mayo Clinic ◽  
Clinical Characteristics ◽  
Conflicts Of Interest ◽  
Local Treatment ◽  
Stage I ◽  
Single Institution ◽  
History Of ◽  
The Impact

Abstract Abstract 1580 Background: Extranodal Marginal Zone Lymphomas of Mucosa Associated Lymphoid Tissue (MALT) account for approximately 5% of all non-Hodgkin Lymphoma cases. Specific MALT lymphomas are characterized by distinct clinical features, treatment strategies, and outcome, depending on site of the disease. While previous reports have described clinical course and treatment of gastric and pulmonary MALT lymphomas, a paucity of data exist describing primary parotid MALT lymphoma. This is a single institution experience. Methods: Patients with primary parotid MALT lymphoma were identified from the Mayo Clinic Lymphoma Database since 1986. This database includes all consenting patients with lymphoma seen at Mayo Clinic Rochester. Clinical characteristics, treatment, and outcomes were collected. Pathology was reviewed by a lymphoma pathologist; WHO criteria were used for diagnosis. PFS and OS were assessed using the Kaplan-Meier method and Cox proportional hazard model was used to asses the impact of variables on PFS and OS. Results: Seventy-six consecutive patients with primary parotid MALT lymphoma were evaluated and treated at Mayo Clinic from 1986 to 2010. The median age at diagnosis was 60 years (18–90). 58 (76%) were female. 42 (55.3%) patients had a history of Sjögren's Disease and 51 (67.1%) had a history of autoimmune disorders. 52 (68.4%), 4 (5.3%), and18 (23.7%) had stage I, II, and IV disease, respectively. 2 cases did not have complete staging information. 6 (7.8%) and 2 (2.6 %) had bone marrow and lung involvement, respectively. No patients had GI tract, liver, or CNS involvement. Median estimated OS (overall survival) was 18.3 years and median PFS (progression free survival) was 7.9 years. ALC<0.96 (p=0.0162) were associated with shorter survival. Age, ECOG performance score, stage, LDH, and history of Sjögren's disease were not prognostic for overall survival. The treatment approach and PFS are outlined in the table. For stage I disease, outcomes were excellent with local therapy. The median estimated PFS was 7.9 years with 72% of patients undergoing surgery surviving at 8 years. Patients receiving radiotherapy had an estimated median PFS of 15.7 years and median OS of 18.3 years. In contrast, patients being observed had a median PFS of 5.5 years. The use of systemic therapy with chemotherapy, immunotherapy or in combination was associated with a median PFS of 7.4 years. Summary: Primary parotid MALT lymphoma is strongly associated with Sjögren's disease. This lymphoma is usually limited to the parotid and associated with a favorable prognosis. For limited disease, local treatment with radiation or surgery appears to be an effective treatment options. For extensive disease, both immunotherapy and chemotherapy are efficacious treatments. Further prospective studies and long-term follow up are needed to determine the optimal treatment approaches and efficacy of chemotherapy/immunotherapy regimens. Disclosures: No relevant conflicts of interest to declare.

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

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.

Outcome in Relation to Treatment Modalities in 48 Patients with Localized Gastric MALT Lymphoma: A Retrospective Study of Patients Treated During 1976-2001

2003 ◽  
Vol 44 (2) ◽  
pp. 257-262 ◽  
Author(s):  
Catherine Thieblemont ◽  
Charles Dumontet ◽  
Fadhela Bouafia ◽  
Olivier Hequet ◽  
Philippe Arnaud ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Malt Lymphoma ◽  
Treatment Modalities ◽  
Gastric Malt Lymphoma

scholarly journals Clinicopathological Features and Treatment Outcomes in Parotid Malignancies at Ocean Road Cancer Institute, Dar-es-Salaam, Tanzania

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 192s-192s
Author(s):  
A. Adatia
Keyword(s):  
Overall Survival ◽  
Retrospective Study ◽  
Parotid Gland ◽  
Treatment Outcomes ◽  
Salivary Glands ◽  
Dar Es Salaam ◽  
Treatment Modalities ◽  
Curative Intent ◽  
Geographical Variations ◽  
Pathologic Features

Background: Neoplasms that arise in the salivary glands are relatively rare, yet they represent a wide variety of both benign and malignant histologic subtypes. Tumors of the salivary glands form one of the most heterogeneous groups of oncological pathology. Head and neck tumors represent ∼5% of human neoplasms, and out of these, salivary gland neoplasms constitute 10%. Aim: The challenges faced for parotid gland malignancy are numerous and these factors determine the treatment modality, prognosis and outcome, overall survival, sociodemographic features affecting Tanzanian residents and there is very little knowledge on clinicopathological aspects of parotid gland malignancies diagnosed at a tertiary health center and this study can compare the findings with epidemiologic data from different geographic locations. Methods: A Retrospective study design was used among all patients who had been diagnosed and confirmed histologically with malignant Parotid tumor referred to and treated at Ocean Road Cancer Institute (ORCI) from January 2009-December 2016. Analysis of this retrospective study determined the sociodemographic factors, clinico-pathologic features, treatment outcomes of surgery, radiotherapy, chemotherapy and assessment of 2 years overall survival of parotid malignancies from January 2009 to December 2014. The study was conducted at ORCI in Dar es Salaam. Results: Out of 94 patients with histologically confirmed parotid gland malignancy, more males were affected compared with females with the ratio of 1.18:1 and the mean SD age of patients was 51.9 years. Adenocarcinoma was the most common malignant tumor n = 37 (40%) followed by squamous cell carcinoma n = 18 (19.1%) and the left parotid gland being the most affected site. 44 cases (46.8%) had pathologic grading, grade IV accounting for majority of the grades (27.3%). Stage IV was presented the most n=72 (76.5%) and 8.5% presented with metastasis at diagnosis. 31% of patients were subjected to surgery while 69.1% were deemed to be unfit for surgery due to advanced disease. Radiotherapy was received by n = 82 (95.2%) with 13 patients (14%) subjected to curative intent and 69 patients (86%) subjected to palliative intent. 2 year overall survival for the curative cohort from 2009-2014 is 23% and 11% for the palliative arm. The 2 year overall survival of parotid gland malignancy treated at ORCI is 12%. Conclusion: Clinico-pathologic presentation of parotid gland malignancy seen in this study differs from other studies probably due to geographical variations. More males are affected than women, especially in the middle ages. Adenocarcinoma was the most frequent histology. Two years overall survival from 2009 to 2014 was 12%. Late stage presentation was seen as a problem that needs to addressed to maximize the effectiveness of the treatment, and improve the overall survival. Treatment modalities need to be standardized across health facilities in Tanzania.

FA03.05: NEOADJUVANT CHEMOTHERAPY OR CHEMORADIOTHERAPY FOR ADENOCARCINOMA OF THE ESOPHAGUS

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 7-7
Author(s):  
Els Visser ◽  
David Edholm ◽  
Mark Smithers ◽  
Iain Thomson ◽  
Bryan Burmeister ◽  
...  
Keyword(s):  
Overall Survival ◽  
Postoperative Complications ◽  
Neoadjuvant Chemotherapy ◽  
Propensity Score ◽  
Hospital Mortality ◽  
Propensity Score Matching ◽  
Survival Rates ◽  
Neoadjuvant Chemoradiotherapy ◽  
Treatment Modalities ◽  
The Impact

Abstract Background Multimodality treatment of patients with esophageal adenocarcinoma (EAC) improve survival, but the optimal treatment strategy remains undetermined. The aim of this study was to compare outcomes in patients undergoing neoadjuvant chemotherapy (nCT) and neoadjuvant chemoradiotherapy (nCRT) for EAC. Methods Patients who underwent nCT or nCRT followed by surgery for EAC were identified from a prospective database (2000–2017) and included in this study. After propensity score matching, we compared the impact of the treatments on postoperative complications, in-hospital mortality, pathological outcomes and survival rates. Results Of the 396 eligible patients, 262 patients were analysed following propensity score matching. This resulted in 131 patients in the nCT group versus 131 patients in the nCRT group. There were no significant differences between the nCT and nCRT groups for overall complications (59% vs 57%, P = 0.802) or in-hospital mortality (2% vs 0%, P = 0.156). Patients who had nCRT had more R0 resections (93% vs. 83%, P = 0.013), and a higher pathological complete response rate (15% vs. 5%, P < 0.001). The pattern of recurrence was similar (P = 0.753) and there were no differences in 5-year disease-free survival rates (nCT vs nCRT; 39% vs 39%, P = 0.879) or 5-year overall survival rates (nCT vs nCRT; 44% vs 33%, P = 0.645). Conclusion In this study no differences between nCT and nCRT were seen in postoperative complications and in-hospital mortality in patients treated for EAC. Inspite of improved complete resection and pathological response there was no difference in the overall survival between the treatment modalities. Disclosure All authors have declared no conflicts of interest.

Impact of hospital volume and type on survival in hepatocellular carcinoma: Results from the National Cancer Database.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 417-417
Author(s):  
Johannes Uhlig ◽  
Cortlandt Sellers ◽  
Sajid A. Khan ◽  
Charles Cha ◽  
Hyun S. Kevin Kim
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Surgical Resection ◽  
Hospital Volume ◽  
Private Insurance ◽  
Cox Proportional Hazards ◽  
Treatment Modalities ◽  
National Cancer Database ◽  
Low Volume ◽  
The Impact

417 Background: To assess the impact of hospital volume and type on survival in patients with hepatocellular carcinoma (HCC). Methods: Patients with histopathological or imaging-based diagnosis of HCC were identified from the 2003-2015 National Cancer Database (NCDB). First-line treatment was stratified as liver transplant, surgical resection, interventional oncology (IO) and chemotherapy. Hospital volume was stratified as high (ranking among top 10% in case numbers) and low volume, separately for each treatment modality. Hospital type was categorized as academic and non-academic. Overall survival was assessed using multivariable Cox proportional hazards models. Results: A total of 63,877 patients were included (transplant n = 10,596, surgical resection n = 11,132, IO n = 12,286, chemotherapy n = 29,863). Of 1,261 hospitals systems which treated HCC, 226 (17.9%) were academic centers and 1,035 (82.1 %) were non-academic centers. Mean number of cases treated annually was higher in academic centers (55.2; 34.6; 40.7; 79.9) versus non-academic centers (10.7; 6.25; 6.6; 11.9 for transplant; surgical resection; IO and chemotherapy; p < 0.001, respectively). Young African American patients and those with private insurance, high income and education were more likely to receive treatment at academic centers. Geographical difference were evident among US regions, with highest proportion of HCC treated at academic centers in New England states (83.6%) and lowest in South Atlantic states (48.6%). Overall survival was superior for academic versus non-academic centers (HR = 0.89, 95% CI: 0.87-0.91, p < 0.001) and high versus low volume centers (HR = 0.79, 95% CI: 0.77-0.81, p < 0.001), after multivariable adjustment for potential confounders. These effects were evident among all HCC treatment modalities. Conclusions: HCC treatment in academic centers shows distinct patterns according to patient demographics and US geography. Among all treatment modalities, both academic setting and hospital volume independently affected HCC outcomes, with highest patient survival observed in high-volume academic centers.

Association of Obesity and Luminal Subtypes in Prognosis and Adjuvant Endocrine Treatment Effectiveness Prediction in Chinese Breast Cancer Patients

2021 ◽  
Author(s):  
Siyi Zhu ◽  
Yiwei Tong ◽  
Weiguo Chen ◽  
Xiaosong Chen ◽  
Kunwei Shen
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Endocrine Therapy ◽  
Clinicopathological Characteristics ◽  
Obese Group ◽  
Treatment Modalities ◽  
Endocrine Treatment ◽  
Breast Cancer Patients ◽  
The Impact

Abstract Purpose Our purpose was to evaluate the influence of obesity on clinicopathological characteristics of breast cancer. Secondly we wanted to explore the effect of obesity on the performance of endocrine therapy in Chinese breast cancer patients. Methods Patients with luminal/human epidermal growth factor receptor 2 (HER2)-negative early breast cancer were included and categorized into the non-obese (BMI < 28 kg/m²) and obese (BMI ≥ 28 kg/m²) groups according to body mass index (BMI). Clinicopathological characteristics and treatment modalities were compared among two groups. Furthermore, the interaction of adjuvant endocrine therapy and efficacy between non-obese and obese groups were analyzed. Results A total of 2875 patients were included: 2598 in the non-obese group and 277 in the obese group. A higher rate of patients with comorbidities (OR: 2.83, 95%CI 2.13–3.74, P < 0.001) or PR positive tumor (OR: 1.63, 95%CI 1.03–2.58, P = 0.037) were identified in the obese group. Obesity was not associated with disease recurrence (P = 0.839) or overall survival (P = 0.140) in the whole population. Subgroup analysis did show an association with worse relapse-free survival (RFS, HR 3.48, 95%CI 1.31–9.22, P = 0.012) and overall survival (OS, HR 4.67, 95%CI 1.28–16.95, P = 0.019) in luminal A breast cancer. These results could not be reproduced in the luminal B subtype with a RFS (HR 0.78, 95%CI 0.41–1.49, P = 0.454) or OS (HR 1.17, 95%CI 0.50–2.74, P = 0.727). Furthermore, obesity didn’t impact endocrine therapy effectiveness, neither in Tamoxifen nor aromatase inhibitor group (RFS: interact P = 0.381; OS: interact P = 0.888). Conclusion The impact of obesity on prognosis interacted with luminal subtype status in Chinese breast cancer patients, which was not related with endocrine treatment modality.

Diffuse Large B-Cell Transformation in Nodular Lymphocyte Predominant Hodgkin Lymphoma: Incidence, Risk Factors and Outcomes After a Forty-Year Experience From a Single Institution

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1525-1525
Author(s):  
Saad J. Sirop ◽  
Thomas M Habermann ◽  
William R Macon ◽  
Kay M. Ristow ◽  
Stephen M Ansell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Radiation Therapy ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Mayo Clinic ◽  
Single Institution ◽  
Incidence Risk ◽  
Large B Cell

Abstract Abstract 1525 Background: Nodular lymphocyte predominant Hodgkin Lymphoma (NLPHL) is a more indolent form of Hodgkin Lymphoma that is usually associated with favorable outcomes. However, a number of reports have shown a tendency of transformation to more aggressive types of lymphoma, typically diffuse large B-cell lymphoma (DLBCL). Long-term data on the incidence and outcomes of transformed NLPHL is lacking in the literature. The aim of this study was to evaluate incidence, risk factors and outcomes of DLBCL transformation in NLPHL in a cohort of patients followed at a single institution. Methods: The actively maintained Mayo Clinic Lymphoma Database includes all consenting consecutive patients with lymphoma seen at Mayo Clinic Rochester. This was used to retrospectively identify patients with NLPHL. The study was approved by the Institutional Review Board. Pathology was reviewed by a hematopathologist and all transformations were histologically confirmed by WHO criteria. The clinical characteristics, therapy and outcomes of patients with NLPHL and DLBCL transformation were analyzed. The chi-square test was used to compare variables. Risk of progression was calculated using a person-year approach. Survival and freedom from transformation were estimated and compared using the Kaplan Meier method and log rank tests, respectively. Results: Between 1970 and 2010, 222 consecutive adult patients with NLPHL were identified. The median follow-up was 20 years. Of these, 17 (7.7%) developed a transformation to DLBCL during the course of the disease (Figure 1). The median time to transformation was 35 (6–248) months. Of these 17 patients, 13 (76.5%) were male, 11 (64.7%) had stage I/II and 6 (35.3%) had stage III/IV NLPHL. Transformation was the first relapse in most patients (12 patients, 70.6%) while five patients (29.4%) developed one or more relapses of NLPHL before transformation. Prior therapies for NLPHL were as follows: radiation therapy in 5 (29.4%), chemotherapy in 5 (29.4%) and combined chemotherapy and radiation in 6 (35.3%) patients. The median age at transformation was 45 years (30–87). Most patients (10 patients, 58.8%) presented with signs (palpable lymph nodes) or “B” symptoms. Eight patients (47.1%) had stage III/IV disease at the time of transformation. The most commonly used regimens for treatment of DLBCL were R-CHOP or CHOP (9 patients, 52.9%). Platinum based therapy was administered in 4 (23.5%) patients. Five patients (29.4%) required more than one line of therapy, and autologous stem cell transplant was utilized in two (11.7%) patients. Based on the observed 17 transformations during 2304 patient-years of follow-up, the rate of transformation was 0.74 per 100 patient-years. The five-year overall survival (OS) of patients with transformed disease (calculated from time of transformation) was 76.4%. The most common cause of death was lymphoma (75%). Following treatment for transformation, 5 patients (29.4%) relapsed. The OS in transformed patients was independent of prior therapies, and transformation did not adversely affect overall survival in our cohort (median survival of in 129 months in transformed versus 120 in non-transformed patients, P=0.33). In a univariate analysis of prior therapies, use of radiation therapy was associated with a significant delay in time to transformation (P= 0.0035) (Table 1, figure 2). Conclusions: The risk of transformation in NLPHL is 0.74% per year in this large single institution case series of NLPHL, and appears to be lower than that observed in follicular and other types of low grade lymphoma. The outcomes of patients with transformation were significantly better than reported in other types of transformed lymphoma and did not adversely affect OS. Disclosures: No relevant conflicts of interest to declare.

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