Heterogeneity of clinical management of low-grade gastric lymphoma of mucosa-associated lymphoid tissue. An audit of 198 patients in Spain.

Puig I, Sanabria E, Feu F, Couto I, Blanco M, Alonso P, Gisbert JP, McNicholl AG, Seoane A, Bory F, Polo F, Orivé V, Ponce J, Borda F, Hervás A, Pérez-Aisa Á, Rivera R, Quintero E, Nicolás-Pérez D, Bujanda L, Rodrigo L, Calvet X; Spanish Gastroenterological Association Gastroduodenal Diseases Study Group.

Gastroenterol Hepatol. 2020 Feb;43(2):79-86. doi: 10.1016/j.gastrohep.2019.08.012. Epub 2019 Nov 29. PMID: 31787375

Abstract

Introduction: Cure of Helicobacter pylori infection in patients with gastric lymphoma of mucosa-associated lymphoid tissue (MALT) leads to long-term clinical remission in the initial stages. As it is a rare disease, its management in clinical practice remains largely unknown and heterogeneity of care remains a concern. The aim was to audit the management and evolution of a large series of low-grade gastric MALT lymphomas from thirteen Spanish hospitals.

Materials and methods: Multicentre retrospective study including data on the diagnosis and follow-up of patients with gastric low-grade MALT lymphoma from January 1998 to December 2013. Clinical, biological and pathological data were analyzed and survival curves were drawn.

Results: One-hundred and ninety-eight patients were included. Helicobacter pylori was present in 132 (69%) patients and 103 (82%) in tumors confined to the stomach (stage EI) and was eradicated in 92% of patients. Chemotherapy was given in 90 (45%) patients and 43 (33%) with stage EI. Marked heterogeneity in the use of diagnostic methods and chemotherapy was observed. Five-year overall survival was 86% (89% in EI). Survival was similar in EI patients receiving aggressive treatment and in those receiving only antibiotics (p=0.577).

Discussion: Gastric MALT lymphoma has an excellent prognosis. We observed, however, a marked heterogeneity in the use of diagnostic methods or chemotherapy in early-stage patients.

Keywords: Disease management; Estudios de seguimiento; Follow-up studies; Linfoma; Lymphoma; Mortalidad; Mortality; Neoplasias malignas; Stomach neoplasms; Tratamiento de la enfermedad.