Management of Stage IE Primary Gastric Lymphoma

Durr, E. Dolores; Bonner, James A.; Strickler, John G.; Martenson, James A.; Chen, M G; Habermann, Thomas M.; Jp, Donohue; Earle, John D.; Grill, Joseph P.

doi:10.1159/000203975

Cited by 18 publications

(6 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients' number 5-year DFS (%) 3-year OS (%) 5-year OS (%) Prognostic factor Medina-Franco et al [ [18] U S A 1 9 7 5 -1 9 9 1 3 5 6 3 -DLCL Lybeert et al [23] The in others, most common subtypes were MALT and DLCL, Table 1. Subtype in some studies was a prognostic factor, however, our study findings revealed no difference among the subtypes regarding the survival rate (Table 3).…”

Section: Author [Ref]mentioning

confidence: 99%

Primary Non-Hodgkin’s Lymphoma of Stomach: To Report 54 Patients and Analysis of Major Reported Series

et al. 2013

View full text Add to dashboard Cite

Introduction. This study aimed to report the characteristics, prognostic factors, and treatment outcomes of 54 patients with primary gastric lymphoma.Materials and Methods. This retrospective study was carried out by reviewing the medical records of 54 adult patients diagnosed at a tertiary academic hospital. All the patients were treated with curative intent. Forty-four patients (81.5%) underwent gastrectomy followed by adjuvant chemotherapy and/or radiotherapy, whereas 10 ones (18.5%) were treated with chemotherapy alone or with radiotherapy.Results. The study was conducted on 25 males and 29 females with the median age of 50 years. Diffuse large B-cell lymphoma (DLCL) (67%) and Mucosa Associated Lymphoid Tissue (MALT) lymphoma (26%) were the most common histologic types. Besides, 36 (59%), 16 (30%), 5 (9%), and 1 (2%) patients were in stages I, II, III, and IV, respectively. The 5-year disease-free survival and overall survival were 64.7% and 67%, respectively. In univariate analysis for overall survival, International Prognostic Index (IPI) (), the WHO performance status (), Ann Arbor stage (), age (), and LDH serum level () were the prognostic factors.Conclusion. Gastric lymphoma tends to present in early stage of the disease and has a favorable outcome.

show abstract

Section: Author [Ref]mentioning

confidence: 99%

Primary Non-Hodgkin’s Lymphoma of Stomach: To Report 54 Patients and Analysis of Major Reported Series

et al. 2013

View full text Add to dashboard Cite

show abstract

“…In the past, PGL has been treated with surgery, consisting of partial or total gastrectomy [1, 2]. Recently, radiotherapy with or without chemotherapy has been recommended as an alternative treatment method to radical gastrectomy in an attempt to preserve the stomach.…”

Section: Discussionmentioning

confidence: 99%

Hepatic dysfunction after radiotherapy for primary gastric lymphoma

Tanaka

Hayashi

Ohtakara

et al. 2012

Journal of Radiation Research

View full text Add to dashboard Cite

Patients with primary gastric lymphoma (PGL) are often treated with three-dimensional conformal radiotherapy (3D-CRT) in three to four fields to reduce the dose to the left kidney. However, the liver dose is higher than conventional parallel-opposed fields. This study was designed to evaluate hepatic dysfunction after 3D-CRT in patients with PGL. The data of 20 PGL patients treated with 3D-CRT were analyzed. Of the 20 patients, 3 had mucosa-associated lymphoid tissue (MALT) lymphoma and 17 had diffuse large B-cell lymphoma (DLBCL). The median dose used to treat MALT lymphoma was 30 Gy and 40 Gy for DLBCL. Pretreatment and post-treatment transaminase and alkaline phosphatase (ALP) values were compared. Radiation-induced hepatic dysfunction (RIHD) was defined as a more than 2-fold increase in transaminase or ALP levels, exceeding the upper limit within 4 months of the completion of radiotherapy. Increased transaminase or ALP levels were observed in 19 patients (95%). RIHD was observed in 14 patients (70%). The transaminase and ALP values were significantly different between pretreatment and post-treatment. There were significant differences in liver volumes receiving ≥5, ≥10, ≥15 and ≥20 Gy (V5, V10, V15 and V20) and in the mean liver doses between patients with and without RIHD. For patients with V10 > 60%, V15 > 50% or V20 > 30% in particular, the incidence rates of RIHD were significantly high. After radiotherapy for PGL, hepatic dysfunction occurred at a high rate. Thus, radiotherapy treatment should be planned in order to reduce liver doses.

show abstract

“…During the early 1990s, some authors had suggested that chemotherapy alone was effective for the sole management therapy modality and may also have been sufficiently effective to prevent the morbidity associated with gastrectomy, such a conservative approach supporting gastric preservation for subsequent residual diseases [16][17][18][19]. Further, yet other authors have recommended surgery as being able to affect a cure for primary gastric lymphoma, particularly for stage IE disease [20][21][22]. Those researchers who suggested surgery either with or without associated chemotherapy focused on the accurate staging of the tumor, less hemorrhage or perforation of the stomach during the treatment; although subsequent to the development of endoscopic ultrasound, the role of laparotomy biopsy has, ultimately, become unwarranted [20].…”

Section: Role Of Surgerymentioning

confidence: 99%

“…The issue of optimal treatment for localized PGL has not been resolved. In the 1980s, gastrectomy, because of its low surgery-related mortality (2% -5%), was used to treat PGL [20][21][22][23]. According to results from the Mayo Clinic, the 5-year-survival rate was reported to reach 75% with curative resection, and 32% with palliative resection [14].…”

Section: The Controversies Of Primary Treatment Of Pglmentioning

confidence: 99%

Current Treatment and Controversy of Primary Gastric Lymphoma

Chang¹

2013

JCT

View full text Add to dashboard Cite

Primary gastric lymphoma (PGL) is not a common cancer and account for 10% of malignant lymphoma and 5% of gastric cancer. The correlation with Helicobacter pylori (H. pylori) infection with mucosa associated lymphoepithelial tumor (MALT) is now well documented and some of the low grade MALT can be cured sorely by triple agent eradication therapy. The most common type of PGL is diffuse large B cell lymphoma which now can be successfully treated with chemotherapy alone. There is still no consensus on the optimal treatment for PGL. In the recent 10 years chemotherapy combined with anti-CD 20 monoclonal antibody such as rituximab, achieved higher complete response rate and more than 80% are long-term survival. The so-called R-CHOP (rituximab, cyclophosphamide, vincristin, prednisolone) now become the new gold standard therapy. The role of surgical resection prior to chemotherapy is controversial and not commonly applied in recent publications. Yet some cases of suboptimal response to R-CHOP or patient is too fragile to tolerate the immuno-chemotherapy will be feasible to surgical resection as a salvage or alternative therapy. The radiotherapy as an adjuvant therapy is less commonly considered. Patients with advanced PGL with high international prognostic index risk and along with co-morbidity diseases are prone to get treatment related complications from above-mentioned modality of treatment, such as GI perforation, neutropenic septicemia, pulmonary infection, fulminate heaptitis B reactivation, respiratory and cardiac impairment can be seen.

show abstract

Management of Stage IE Primary Gastric Lymphoma

Cited by 18 publications

References 18 publications

Primary Non-Hodgkin’s Lymphoma of Stomach: To Report 54 Patients and Analysis of Major Reported Series

Primary Non-Hodgkin’s Lymphoma of Stomach: To Report 54 Patients and Analysis of Major Reported Series

Hepatic dysfunction after radiotherapy for primary gastric lymphoma

Current Treatment and Controversy of Primary Gastric Lymphoma

Contact Info

Product

Resources

About