Long-term results of stomach-conserving therapy in gastric MALT lymphoma

• Published in: Radiotherapy and oncology Vol. 87; no. 3; pp. 405 - 411
• Main Authors: Vrieling, Conny, de Jong, Daphne, Boot, Henk, de Boer, Jan Paul, Wegman, Froukje, Aleman, Berthe M.P.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.06.2008
• Subjects: Adult; Aged; Aged, 80 and over; Combined Modality Therapy; Conservative treatment; Female; Follow-Up Studies; Gastric MALT lymphoma; Helicobacter Infections - complications; Helicobacter Infections - drug therapy; Helicobacter pylori; Hematology, Oncology and Palliative Medicine; Humans; Lymphoma, B-Cell, Marginal Zone - microbiology; Lymphoma, B-Cell, Marginal Zone - mortality; Lymphoma, B-Cell, Marginal Zone - pathology; Lymphoma, B-Cell, Marginal Zone - therapy; Male; Middle Aged; Neoplasm, Residual; pMRD; Prognosis; Radiotherapy; Remission Induction; Stomach Neoplasms - microbiology; Stomach Neoplasms - mortality; Stomach Neoplasms - pathology; Stomach Neoplasms - therapy; Survival Rate; Gastric MALT lymphoma; pMRD; Radiotherapy; Conservative treatment
• ISSN: 0167-8140; 1879-0887
• DOI: 10.1016/j.radonc.2008.02.012

To evaluate long-term results of stomach-conserving therapy and to assess the value of histological probable minimal residual disease (pMRD) in predicting outcome in patients with gastric MALT lymphoma. We studied 115 patients with stage I–II 2 gastric MALT lymphoma treated between 1975 and 2002. Initially, first-line treatment consisted of radiotherapy only. Since 1994 most patients were primarily treated with Helicobacter pylori eradication; radiotherapy was used in case of eradication failure. To assess the value of pMRD, first follow-up biopsy samples classified as compete remission (CR) according to classical clinico-pathological criteria and biopsy samples 1 year after assessment of histological CR were reviewed; results were related to outcome. Following radiotherapy only ( n = 56) 96% achieved a clinical CR; 10-year cancer-specific survival rate was 94%. Following H. pylori eradication only ( n = 35) CR-rate was 43% and after additional treatment 89%; 5-year cause-specific survival was 93%. There was no difference in relapse rate following initial histological CR or pMRD. Patients with early stage gastric MALT lymphoma have a favorable long-term outcome following conservative treatment. Outcome after H. pylori eradication followed by delayed radiotherapy on indication was excellent. In our series pMRD was not associated with increased risk of recurrence.