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Matysiak-Budnik T, Priadko K, Bossard C, Chapelle N, Ruskoné-Fourmestraux A. Clinical Management of Patients with Gastric MALT Lymphoma: A Gastroenterologist's Point of View. Cancers (Basel) 2023; 15:3811. [PMID: 37568627 PMCID: PMC10417821 DOI: 10.3390/cancers15153811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
Gastric mucosa-associated lymphoid tissue (MALT) lymphomas (GML) are non-Hodgkin lymphomas arising from the marginal zone of the lymphoid tissue of the stomach. They are usually induced by chronic infection with Helicobacter pylori (H. pylori); however, H. pylori-negative GML is of increasing incidence. The diagnosis of GML is based on histological examination of gastric biopsies, but the role of upper endoscopy is crucial since it is the first step in the diagnostic process and, with currently available novel endoscopic techniques, may even allow an in vivo diagnosis of GML per se. The treatment of GML, which is usually localized, always includes the eradication of H. pylori, which should be performed even in H. pylori-negative GML. In the case of GML persistence after eradication of the bacteria, low-dose radiotherapy may be proposed, while systemic treatments (immunochemotherapy) should be reserved for very rare disseminated cases. In GML patients, at diagnosis but even after complete remission, special attention must be paid to an increased risk of gastric adenocarcinoma, especially in the presence of associated gastric precancerous lesions (gastric atrophy and gastric intestinal metaplasia), which requires adequate endoscopic surveillance of these patients.
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Affiliation(s)
- Tamara Matysiak-Budnik
- IMAD, Hepato-Gastroenterology & Digestive Oncology, University Hospital of Nantes, 44093 Nantes, France; (K.P.); (N.C.)
- Inserm, CHU Nantes, University of Nantes, Centre de Recherche en Transplantation et Immunologie, UMR 1064, ITUN, 44000 Nantes, France
| | - Kateryna Priadko
- IMAD, Hepato-Gastroenterology & Digestive Oncology, University Hospital of Nantes, 44093 Nantes, France; (K.P.); (N.C.)
- Hepato-Gastroenterology Unit, University Hospital Universita degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | | | - Nicolas Chapelle
- IMAD, Hepato-Gastroenterology & Digestive Oncology, University Hospital of Nantes, 44093 Nantes, France; (K.P.); (N.C.)
- Inserm, CHU Nantes, University of Nantes, Centre de Recherche en Transplantation et Immunologie, UMR 1064, ITUN, 44000 Nantes, France
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Yang J, Liu T, Zhu Y, Zhang F, Zhai M, Zhang D, Zhao L, Jin M, Lin Z, Zhang T, Zhang L, Yu D. A dynamic predictive nomogram of long-term survival in primary gastric lymphoma: a retrospective study. BMC Gastroenterol 2022; 22:347. [PMID: 35842604 PMCID: PMC9288002 DOI: 10.1186/s12876-022-02419-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 07/08/2022] [Indexed: 11/29/2022] Open
Abstract
Background Primary gastric lymphoma (PGL) is the most common extranodal non-Hodgkin lymphoma (NHL). Due to the rarity of the disease, it is important to create a predictive model that provides treatment and prognosis for patients with PGL and physicians. Methods A total of 8898 and 127 patients diagnosed with PGL were obtained from the SEER database and from our Cancer Center as training and validation cohorts, respectively. Univariate and multivariate Cox proportional hazards models were used to investigate independent risk factors for the construction of predictive survival nomograms, and a web nomogram was developed for the dynamic prediction of survival of patients with PGL. The concordance index (C-index), calibration plot, and receiver operating characteristics (ROC) curve were used to evaluate and validate the nomogram models. Results There were 8898 PGL patients in the SEER cohort, most of whom were married men over the age of 60, 16.1% of the primary tumors were localized in the antrum and pylori of the stomach, which was similar to the composition of 127 patients in the Chinese cohort, making both groups comparable. The Nomogram of overall survival (OS) was compiled based on eight variables, including age at diagnosis, sex, race, marital status, histology, stage, radiotherapy and chemotherapy. Cancer-specific survival (CSS) nomogram was developed with eight variables, including age at diagnosis, sex, marital status, primary tumor site, histology, stage, radiotherapy and chemotherapy. The C-index of OS prediction nomogram was 0.948 (95% CI: 0.901–0.995) in the validation cohort, the calibration plots showed an optimal match and a high area below the ROC curve (AUC) was observed in both training and validation sets. Also, we established the first web-based PGL survival rate calculator (https://yangjinru.shinyapps.io/DynNomapp/). Conclusion The web dynamic nomogram provided an insightful and applicable tool for evaluating PGL prognosis in OS and CSS, and can effectively guide individual treatment and monitoring. Supplementary Information The online version contains supplementary material available at 10.1186/s12876-022-02419-2.
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Affiliation(s)
- Jinru Yang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Tao Liu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Ying Zhu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Fangyuan Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Menglan Zhai
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Dejun Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Lei Zhao
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Min Jin
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Zhenyu Lin
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Tao Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China
| | - Liling Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.
| | - Dandan Yu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.
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Shimohigashi Y, Toya R, Saito T, Kono Y, Doi Y, Fukugawa Y, Watakabe T, Matsumoto T, Kai Y, Maruyama M, Oya N. Impact of four-dimensional cone-beam computed tomography on target localization for gastric mucosa-associated lymphoid tissue lymphoma radiotherapy: reducing planning target volume. Radiat Oncol 2021; 16:14. [PMID: 33446225 PMCID: PMC7807891 DOI: 10.1186/s13014-020-01734-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 12/17/2020] [Indexed: 12/27/2022] Open
Abstract
Background Radiotherapy of gastric mucosa-associated lymphoid tissue (MALT) lymphoma should be delivered to the entire stomach with planning target volume (PTV) that accounts for variations in stomach volume, respiratory movement, and patient set-up error. In this study, we evaluated whether the use of four-dimensional cone-beam computed tomography (4D-CBCT) reduces the PTV. Methods Eight patients underwent radiotherapy with 15 fractions of gastric MALT lymphoma using 4D-CBCT. PTV structures of 5–30 mm margins (5 mm intervals) from the clinical target volume (CTV) delineated based on the 4D-CT images (CTV-4D) were generated. For the target localization, we performed matching based on skin marking (skin matching), bone anatomy (bone matching), and stomach anatomy (4D soft-tissue matching) based on registration between planning CT and 4D-CBCT images from 10 phases. For each patient, we calculated the covering ratio (CR) of the stomach with variable PTV structures, based on the 4D-CBCT images, with a total of 150 phases [CR (%) = (number of covering phases/150 phases) × 100], for three target localization methods. We compared the CR values of the different target localization methods and defined the PTV with an average CR of ≥ 95% for all patients. Results The average CR for all patients increased from 17.9 to 100%, 19.6 to 99.8%, and 33.8 to 100%, in the skin, bone, and 4D soft-tissue matchings, respectively, as the PTV structures increased from 5 to 30 mm. The CR obtained by 4D soft-tissue matching was superior to that obtained by skin (P = 0.013) and bone matching (P = 0.008) for a PTV structure of 15 mm margin. The PTV required an additional margin of 20 mm (average CR: 95.2%), 25 mm (average CR: 99.1%), and 15 mm (average CR: 98.0%) to CTV-4D for the skin, bone, and 4D soft-tissue matchings, respectively. Conclusions This study demonstrates that the use of 4D-CBCT reduces the PTV when applying 4D soft-tissue matching, compared to skin and bone matchings. Additionally, bone matching does not reduce the PTV as compared with traditional skin matching.
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Affiliation(s)
- Yoshinobu Shimohigashi
- Department of Radiological Technology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
| | - Ryo Toya
- Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto, Japan
| | - Tetsuo Saito
- Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto, Japan
| | - Yumiko Kono
- Department of Radiological Technology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yasuhiro Doi
- Department of Radiological Technology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yoshiyuki Fukugawa
- Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto, Japan
| | - Takahiro Watakabe
- Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto, Japan
| | - Tadashi Matsumoto
- Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto, Japan
| | - Yudai Kai
- Department of Radiological Technology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Masato Maruyama
- Department of Radiological Technology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Natsuo Oya
- Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto, Japan
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Tian C, Li Y, Chen Z. A Retrospective Analysis of Primary Gastrointestinal Non-Hodgkin Lymphomas: Clinical Features, Prognostic Factors and Treatment Outcomes. Onco Targets Ther 2020; 13:5345-5352. [PMID: 32606752 PMCID: PMC7293986 DOI: 10.2147/ott.s248381] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 05/21/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Primary gastrointestinal non-Hodgkin lymphoma (PGIL) is a rare hematopoietic malignancy with limited data to guide management. Methods We analyzed the clinical characteristics and survival of 219 newly diagnosed PGIL patients. Results Our single-center data showed that the incidence rate of primary gastric lymphoma (PGL) was higher than that of primary intestine lymphoma (PIL). Most PGIL was B-cell originated and DLBCL was the most common pathological type both in PGL and PIL group. Univariate and multivariate analysis showed that IPI score and pathology were independent prognostic factors. The overall survival (OS) and progression-free survival (PFS) of patients with MYC rearrangement were much shorter compared to patients without MYC rearrangement indicating that MYC translocation was related to decreased survival. Neither OS nor PFS differed between patients who received chemotherapy with or without surgery. However, patients who received surgery alone had a poor prognosis. Conclusion Chemotherapy is the front-line treatment for PGIL while surgery was conducted to relieve tumor-related complications or make diagnosis. MYC rearrangement predicted poor prognosis of PGIL patients.
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Affiliation(s)
- Chen Tian
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, People's Republic of China
| | - Yueyang Li
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, People's Republic of China
| | - Zehui Chen
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, People's Republic of China
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Matysiak-Budnik T, Jamet P, Ruskoné-Fourmestraux A, de Mascarel A, Velten M, Maynadié M, Woronoff AS, Trétarre B, Marrer E, Delafosse P, Ligier K, Lapôtre Ledoux B, Daubisse L, Bouzid L, Orazio S, Cowppli-Bony A, Monnereau A. Gastric MALT lymphoma in a population-based study in France: clinical features, treatments and survival. Aliment Pharmacol Ther 2019; 50:654-663. [PMID: 31347731 DOI: 10.1111/apt.15409] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 03/27/2019] [Accepted: 06/18/2019] [Indexed: 02/06/2023]
Abstract
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.
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Peña C, Russo M, Martinez V, Cabrera ME. Extranodal lymphomas in the public health system in Chile: Analysis of 1251 patients from the National Adult Cancer Program. Hematol Oncol 2018; 37:47-53. [PMID: 30117170 DOI: 10.1002/hon.2547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 06/26/2018] [Accepted: 06/30/2018] [Indexed: 12/17/2022]
Abstract
The aim of the study was to describe the clinical and epidemiological characteristics, anatomic and histologic distribution, and treatment results of extranodal lymphomas (ENLs), diagnosed and treated in the public health system in Chile. We included patients with ENL diagnosed from 1998 to 2014, in 17 cancer centers, registered prospectively in the database of the National Adult Cancer Program (PANDA) of the Ministry of Health. Treatment was based on the local protocols for each lymphoma subtype. Extranodal lymphoma was documented in 1215 of 4907 non-Hodgkin lymphomas diagnosed in that period (25%). Median age was 59 years (range, 16-95), and 55% were female. The gastrointestinal (GI) tract was the most common location (38%), followed by the head and neck (24%) and the skin (15%). B-cell lymphomas accounted for 78% of cases, diffuse large B-cell lymphoma being the most common histologic subtype (68%). Mycosis fungoides/Sezary syndrome was the most frequent T-cell subtype (36%), followed by NK/T-cell lymphomanasal type (24%). In comparison with western countries, Chile showed a significantly high prevalence of NK/T-cell lymphoma nasal type, while the frequency of B-cell ENL and the anatomic distribution appeared similar, being GI the most commonly involved site.
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Affiliation(s)
- Camila Peña
- Medicine Service, Hematology Section, Hospital del Salvador, Santiago, Chile
| | - Moises Russo
- Radiation Oncology, Fundación Arturo Lopez Perez, Faculty of Medicine, Diego Portales University, Santiago, Chile
| | | | - Maria Elena Cabrera
- Medicine Service, Hematology Section, Hospital del Salvador, University of Chile, Santiago, Chile
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Wolfesberger B, Fuchs-Baumgartinger A, Greß V, Hammer S, Gradner G, Knödl K, Tichy A, Rütgen B, Beham-Schmid C. World Health Organisation Classification of Lymphoid Tumours in Veterinary and Human Medicine: a Comparative Evaluation of Gastrointestinal Lymphomas in 61 Cats. J Comp Pathol 2018; 159:1-10. [DOI: 10.1016/j.jcpa.2017.12.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 12/11/2017] [Accepted: 12/13/2017] [Indexed: 12/11/2022]
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Toya R, Saito T, Shimohigashi Y, Yotsuji Y, Matsuyama T, Watakabe T, Kai Y, Yamashita Y, Oya N. Four-dimensional cone-beam computed tomography-guided radiotherapy for gastric lymphoma. Jpn J Radiol 2017; 36:159-163. [PMID: 29086348 DOI: 10.1007/s11604-017-0698-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 10/20/2017] [Indexed: 12/11/2022]
Abstract
PURPOSE We describe a treatment method with four-dimensional cone-beam computed tomography (4D-CBCT)-guided radiotherapy for gastric lymphoma. MATERIALS AND METHODS We performed image-guided radiotherapy (IGRT) with 15 fractions for a gastric mucosa-associated lymphoid tissue lymphoma patient, using 4D-CBCT. The stomach was delineated based on 4D-CT images. For image guidance, an automatic registration between planning CT and 4D-CBCT images was performed based on the bony anatomy (bone matching), followed by manual registration based on the stomach in 4D-CBCT images of all 10 phases (4D matching). We calculated the covering ratio (CR) with variable stomach-to-planning target volume (PTV) margins, based on the images of all phases [CR (%) = the number of covering phases/all 150 phases × 100]. RESULTS The patient underwent radiotherapy (RT) as scheduled, without any significant adverse effects. The appropriate PTV margins (CR ≥ 95%) were 25 mm (CR 99.3%) and 15 mm (CR 98.7%) for bone and 4D matching, respectively. CONCLUSION 4D matching using 4D-CBCT is appropriate for IGRT of gastric lymphomas.
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Affiliation(s)
- Ryo Toya
- Department of Radiation Oncology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
| | - Tetsuo Saito
- Department of Radiation Oncology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | | | - Yohei Yotsuji
- Department of Radiological Technology, Kumamoto University Hospital, Kumamoto, Japan
| | - Tomohiko Matsuyama
- Department of Radiation Oncology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Takahiro Watakabe
- Department of Radiation Oncology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yudai Kai
- Department of Radiological Technology, Kumamoto University Hospital, Kumamoto, Japan
| | - Yasuyuki Yamashita
- Department of Diagnostic Radiology, Kumamoto University Hospital, Kumamoto, Japan
| | - Natsuo Oya
- Department of Radiation Oncology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
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Pulte D, Weberpals J, Jansen L, Luttmann S, Holleczek B, Nennecke A, Ressing M, Katalinic A, Brenner H, Geiss K, Meyer M, Eberle A, Luttmann S, Stabenow R, Hentschel S, Nennecke A, Kieschke J, Sirri E, Holleczek B, Emrich K, Kajüter H, Mattauch V, Katalinic A, Eisemann N, Barnes B, Kraywinkel K, Brenner H, Jansen L, Weberpals J. Survival for patients with rare haematologic malignancies: Changes in the early 21st century. Eur J Cancer 2017; 84:81-87. [DOI: 10.1016/j.ejca.2017.07.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 07/06/2017] [Accepted: 07/11/2017] [Indexed: 11/15/2022]
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Delamain MT, da Silva MG, Miranda ECM, Desterro J, Luminari S, Fedina A, Merli F, Chiattone CS, Pagnano KBB, Federico M, de Souza CA. Age-adjusted international prognostic index is a predictor of survival in gastric diffuse B-cell non-Hodgkin lymphoma patients. Rev Bras Hematol Hemoter 2016; 38:247-51. [PMID: 27521863 PMCID: PMC4997895 DOI: 10.1016/j.bjhh.2016.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 04/25/2016] [Indexed: 12/26/2022] Open
Abstract
Background The clinical course of gastric lymphoma is heterogeneous and clinical symptoms and some factors have been related to prognosis. Objective The present study aims to identify prognostic factors in gastric diffuse B-cell non-Hodgkin lymphoma diagnosed and treated in different countries. Methods A consecutive series of gastric diffuse B-cell non-Hodgkin lymphoma patients diagnosed and treated in Brazil, Portugal and Italy, between February 2008 and December 2014 was evaluated. Results Of 104 patients, 57 were female and the median age was 69 years (range: 28–88). The distribution of the age-adjusted international prognostic index was 12/95 (13%) high risk, 20/95 (21%) high-intermediate risk and 63/95 (66%) low/low-intermediate risk. Symptoms included abdominal pain (63/74), weight loss (57/73), dysphagia (37/72) and nausea/vomiting (37/72). Bulky disease was found in 24% of the cases, anemia in 33 of 76 patients and bleeding in 22 of 72 patients. The median follow-up time was 25 months (range: 1–77 months), with 1- and 5-year survival rates of 79% and 76%, respectively. The multivariate Cox Regression identified the age-adjusted international prognostic index as a predictor of death (hazard risk: 3.62; 95% confidence interval: 2.21–5.93; p-value <0.0001). Conclusions This series identified the age-adjusted international prognostic index as predictive of mortality in patients treated with conventional immunochemotherapy.
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Affiliation(s)
| | | | | | - Joana Desterro
- Instituto Português de Oncologia, Departamento de Hematologia, Lisboa, Portugal
| | - Stefano Luminari
- Università di Modena e Reggio Emilia, Clinica e di Sanità Pubblica, Department of Diagnostic Medicine, Modena, Italy
| | - Anna Fedina
- Università di Modena e Reggio Emilia, Clinica e di Sanità Pubblica, Department of Diagnostic Medicine, Modena, Italy
| | | | | | | | - Massimo Federico
- Università di Modena e Reggio Emilia, Clinica e di Sanità Pubblica, Department of Diagnostic Medicine, Modena, Italy
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