Long-term clinical outcomes of gastric mucosa-associated lymphoid tissue lymphoma in real-world experience

Abstract

This long-term, retrospective, single-center study evaluated real-world clinical outcomes of gastric mucosa-associated lymphoid tissue (MALT) lymphoma using different therapeutic modalities and analyzed factors affecting survival outcomes and long-term prognosis. We enrolled 203 patients with pathologically confirmed low-grade gastric MALT lymphoma and examined their treatment responses. Helicobacter pylori eradication was performed in all patients with H. pylori infection (HPI) and localized stage gastric MALT lymphoma. All patients underwent pre-treatment and physical evaluations, with complete blood count, biochemistry panel, and staging workup. Among 144 HPI-positive patients with stage I or II1–2 disease who underwent H. pylori eradication, 112 (77.8%) achieved complete remission (CR). All HPI-negative patients who received first-line radiotherapy achieved CR (100%), but only 22 of 27 first-line chemotherapy-treated patients achieved CR (81.5%). Lesions in the proximal upper-third or in multiple locations and an invasion depth to the submucosa or deeper were associated with poor response to eradication, and HPI negativity was significantly correlated with poor progression-free survival. HPI eradication treatment should be the first-line treatment for patients with localized stage HPI-positive gastric MALT lymphoma. The “watch-and-wait” strategy should be adopted for delayed responders. We suggest radiotherapy for patients with a localized HPI-negative status or when eradication has failed.

The National Landscapes of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma: Stable Trends in Black Populations and Late-Stage Tumors

“…Possible explanations for this discrepancy include differences in H. Pylori prevalence and disparities in access to care and treatment outcomes. Our study covers a larger portion of the US population over a more recent time period (21,625 patients between 2001 and 2020) compared to the prior study (4688 patients between 2000 and 2018), possibly explaining the different results. It is also worth noting that the greatest decrease in incidence rates in all race/ethnic groups in our study was seen in the past few years, which was not analyzed in the prior study by Rustgi et al The prevalence of H. Pylori is significantly higher in Black, Hispanic, and low socio-economic populations [26].…”

“…A prior nationwide analysis of the SEER 18 database, which covers 27.8% of the US population, showed that the age-adjusted incidence rates of gastric MALT lymphoma decreased between 2000 and 2018 [ 19 ]. As for sex-specific differences, most of the literature has found similar incidence rates of gastric MALT lymphoma in both sexes, with variations in studies finding a slight predominance in males or females [ 20 , 21 , 22 , 23 ]. Our study findings echo these results, demonstrating approximately similar incidence rates between males and females.…”