Gastric MALT lymphoma in a population‐based study in France: clinical features, treatments and survival

Abstract

Summary Background Gastric mucosa‐associated lymphoid tissue (MALT) lymphoma is a rare disease, and most available data on gastric MALT lymphoma (GML) come from clinical studies of selected patients treated in centres of excellence. Aims To analyse the clinical features, management and survival of GML patients in a population‐based study in France Methods All new cases of GML diagnosed between 2002 and 2010 in 11 French areas covered by cancer registries were included. Pathology reports were verified and, if necessary, reviewed by an expert pathologist. All clinical data were retrospectively collected from medical files and analysed using stata V. 14 software. Results Four hundred and sixteen patients with confirmed GML (50% male, median age 67 years) were identified. Among them, 44 showed an early transformation into diffuse large B cell lymphoma and were considered to have had an initially missed high‐grade lymphoma. At diagnosis, 76% of patients were at stage IE/II, and 24% at stage III/IV of the disease. Helicobacter pylori infection was found in 57% of the patients. Eradication treatment was administered to 76% of patients and complete remission (CR) was obtained in 39%. One hundred and ninety patients received at least one other treatment, including 10 already in CR after eradication. Altogether, CR was obtained in 70% of patients and the 5‐year overall survival was 79% (95% CI [75‐83]). Conclusions In comparison to clinical series, in the general population, GMLs are more frequently diagnosed at an advanced stage, their clinical management is heterogeneous, and there is a risk of misdiagnosis and overtreatment. These results highlight the necessity of following currently available guidelines in this field.

Dieulafoy disease with gastric MALT lymphoma

“…Related reports indicated that it is frequently diagnosed as an advanced tumour, and misdiagnosis and excessive treatment can occur. [ 13 ] Common endoscopic manifestations of gastric MALT lymphoma include ulcers (45%), intragastric nodules (30%) and pseudogastritis (25%). [ 14 ] The endoscopic findings of a diffuse miliary appearance of gastric mucosa, with slightly white and small protrusions, were reported in 2 cases, and nodular gastric MALT lymphoma was considered and pathologically confirmed.…”

Recent advances in upper gastrointestinal lymphomas: molecular updates and diagnostic implications

“…24 In a retrospective study of >400 cases diagnosed in France between 2002 and 2010, only 57% of the cases were associated with H. pylori. 25 Another point is that the density and detectability of H. pylori have been reported to decrease in association with lymphoma progression. 26,27 In intestinal MALT lymphomas, an association with Campylobacter jejuni infection has been reported, but evidence for a causal link is lacking.…”

“…However, recent analyses have shown a significant reduction in the prevalence of H. pylori infection in gastric MALT lymphomas in Europe as compared with the early 1990s 24 . In a retrospective study of >400 cases diagnosed in France between 2002 and 2010, only 57% of the cases were associated with H. pylori 25 . Another point is that the density and detectability of H. pylori have been reported to decrease in association with lymphoma progression 26,27 .…”

Development and Validation of a Nomogram Predicting The Overall Survival for Patients With Primary Gastric Mucosa‐Associated Lymphoid Tissue Lymphoma: A SEER-Based Study

“…The prognosis of primary GML patients can be affected by many factors. Clinical risk factors, including age, type of therapy, sex, stage and family hematologic malignancy history, also have signi cant effects on the development of the disease [11][12][13][14]. Meanwhile, previous studies demonstrated a good prognosis of the disease, with 5-year survival rates of up to 99%.…”