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Treatment and outcomes of early stage gastric MALT lymphoma



Treatment and outcomes of early stage gastric MALT lymphoma



Gastroenterology. 122(4 Suppl. 1): A-174, Il



BACKGROUND Mucosa associated lymphoid tissue (MALT) {ymphoma often regresses after eradication of Helicobacter pylori (H. pylori) with antibiotics but can prove refractory to this therapy possibly due to autonomous growth. Surgical treatment is associated with morbidity and mortality and may not be curative. Radiotherapy is an effective alternative treatment for patients with gastric MALT lymphoma who do not respond to H. pytori eradication. To determine the optimal treatment for stage IE and stage liE gastric MALT lymphoma, we evaluated our experience with treatment of gastric MALT lymphoma at the Vancouver Cancer Center of the British Columbia Cancer Agency (BCCA). METHODS Retrospectively we analyzed the pattern of disease and the outcomes of treatment using data from 30 patients with stage IE and stage liE gastric MALT lymphoma who were treated between January 1985 and November 2000 at BCCA. RESULTS The mean age of the patients was 62 years (range 39- 90). Distribution by stage was as follows: Twenty-four patients (80%) were stage lEA, one patient (3%) was stage IEB, four patients (13%) were stage IIEA and one patient (3%) was stage IIEB. Treatment consisted of antibiotic regimens (7 patients), surgical resection (9 patients) or radiation therapy (10 patients). One patient was treated with all three (chemotherapy, surgical resection and radiation treatment), one with surgical resection plus radiation therapy, one with surgical resection and chemotherapy and one patient with chemotherapy alone. Two out of 7 patients treated initially with antibiotics had no evidence of disease at the last follow-up. All patients became symptom-free if H. pylori was eradicated (9 patients). The 10-year actuarial relapse free survival rate for stage IE and stage lie patients treated with radiation was 100% The 1g-year actuarial relapse free survival rate for stage IE and stage lie patients treated with surgical resection was 24%. The over all survival for the whole group was 93% at 10 years. CONCLUSIONS The data indicates that radiation therapy is safe, effective and may be the optimal treatment for patients with early stage gastric MALT iymphoma in whom H. pylori can not be demonstrated or is not responsive to antibiotics. Surgery is associated with high risk of relapse.

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Accession: 035980004

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