Chemotherapy for the treatment of patients with primary high grade gastric B-cell lymphoma of modified Ann Arbor stages IE and IIE

Raderer, Markus; Valencak, Julia; Österreicher, C.; Drach, Johannes; Hejna, Michael; Kornek, Gabriela; Scheithauer, Werner; Brodowicz, Thomas; Chott, Andreas; Dragosics, B

doi:10.1002/(sici)1097-0142(20000501)88:9<1979::aid-cncr1>3.0.co;2-l

Cited by 45 publications

(23 citation statements)

References 16 publications

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“…Salvgnol et al reported a survival rate of 71% in patients treated by chemotherapy [55] . Another recent study on aggressive gastrointestinal lymphoma found primary chemotherapy with or without radiotherapy useful and induced a complete response in 81% of patients, with fewer complications compared with surgery including less risk of perforation or bleeding [65] . Other reports showed no apparent difference in survival between patients treated by chemotherapy or surgery and chemotherapy with survival rates of 67% and 60%, respectively.…”

Section: Chemotherapymentioning

confidence: 99%

Primary gastric lymphoma

Al-Akwaa¹,

Siddiqui²,

Al-Mofleh³

2004

WJG

102

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AIM:The purpose of this review is to describe the various aspects of primary gastric lymphoma and the treatment options currently available. METHODS:After a systematic search of Pubmed, Medscape and MDconsult, we reviewed and retrieved literature regarding gastric lymphoma. RESULTS:Primary gastric lymphoma is rare however, the incidence of this malignancy is increasing. Chronic gastritis secondary to Helicobacter pylori (H pylori) infection has been considered a major predisposing factor for MALT lymphoma. Immune histochemical marker studies and molecular biology utilizing polymerase chain reaction have facilitated appropriate diagnosis and abolished the need for diagnostic surgical resection. Advances in imaging techniques including Magnetic Resonance Imaging (MRI) and Endoscopic Ultrasonography (EUS) have helped evaluation of tumor extension and invasion. The clinical course and prognosis of this disease is dependent on histopathological sub-type and stage at the time of diagnosis. Controversy remains regarding the best treatment for early stages of this disease. Chemotherapy, surgery and combination have been studied and shared almost comparable results with survival rate of 70-90%. However, chemotherapy possesses the advantage of preserving gastric anatomy. Radiotherapy alone has been tried and showed good results. Stage IIIE, IVE disease treatment is solely by chemotherapy and surgical resection has been a remote consideration. CONCLUSION:We conclude that methods of diagnosis and staging of the primary gastric lymphoma have dramatically improved. The modalities of treatment are many and probably chemotherapy is superior because of high success rate, preservation of stomach and tolerable complications.Al-Akwaa AM, Siddiqui N, Al-Mofleh IA. Primary gastric lymphoma.

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Section: Chemotherapymentioning

confidence: 99%

Primary gastric lymphoma

Al-Akwaa¹,

Siddiqui²,

Al-Mofleh³

2004

WJG

102

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“…Surgical extirpation, chemotherapy and radiotherapy have been utilized in association or alone (2,3,13,24,25) . Surgical treatment is preferred for the following reasons: (i) more representative samples for histological diagnosis and consequent classification can be obtained; (ii) the risk of serious hemorrhages or perforation of the gastric wall during chemotherapy or radiotherapy treatment of non-removed tumors is eliminated; (iii) more accurate staging; (iv) the possibility of removing lesions before initiating adjuvant chemotherapy and/or radiotherapy increases the chances of success of the treatment; and (v) relief of symptoms (2,4,15,16,28) .…”

Section: Discussionmentioning

confidence: 99%

“…Operative mortality was between 3%-25% with higher rates for palliative procedures, which were performed for symptomatic relief, removal of tumor mass and avoidance of hemorrhage or perforation related to other modes of therapy (1,2,3,4,15,16) . The morbidity, mortality and impairment of life quality generated by gastric resection have led some investigators to avoid gastrectomy, opting instead to treat patients with a conservative approach (10,19,20,24,25,26,29) . A prospective study (26) has found that in stages IE and IIE, the complete response, survival rate and disease free survival Waisberg rates were similar to those who underwent complete resection and partial or no surgery prior to administration of chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…In other studies (10,19,20,34) , the mortality and morbidity related to surgery were similar if not greater than those related to non-surgical treatment for stage I and II. In patients with comorbid factors and increased risk of surgery-related morbidity and mortality, chemotherapy offered an effective or equally effective mode of treatment to surgical resection (24,25,26) . Series have shown the superiority of combined surgery and chemotherapy to single mode with survival rates reaching 86%-94% for stages IE and IIE (13,31,34) .…”

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confidence: 99%

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Curative resection plus adjuvant chemotherapy for early stage primary gastric non-Hodgkin's lymphoma: a retrospective study with emphasis on prognostic factors and treatment outcome

Waisberg¹,

Andre²,

Franco

et al. 2006

Arq. Gastroenterol.

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-Background -There is controversy regarding the optimal therapy for primary non-Hodgkin gastric lymphoma with some authors defending surgical extirpation either alone or in association with radiotherapy and or chemotherapy, especially in relation to the earlier stages of the disease. Aim -To analyze the clinical-pathological features and the results of management approaches for patients with primary early-stage non-Hodgkin's lymphoma of the stomach operated in Surgical Gastroenterology Department, "Hospital do Servidor Público Estadual", São Paulo, SP, Brazil. The literature is reviewed to highlight the aspects of diagnosis, prognostic factors and role of the various treatment regimens. Method -Sixteen patients with primary early-stage gastric lymphoma underwent curative surgical treatment. The variables analyzed were age, sex, location, size, type of surgery, number of lesions, depth of invasion, histological type in accordance with Kiel's classification, involvement of lymph nodes, Ann Arbor stage classification modified by Musshoff and Schmidt-Vollmer, histological grade, margins, adjuvant therapy, clinical course and survival. Results -Ten patients (62.5%) underwent subtotal gastrectomy and six (37.5%) underwent total gastrectomy. The majority (9/56.2%) of the lesions were located in the antrum. Single lesions (10/62.5%) were more frequent than multiple lesions (6/37.5%). Thirteen patients (81.2%) were classified as stage IE and three (18.7%) as stage IIE1. Primary gastric lymphoma classified histologically as low or high grade was presented by 10 (62.5%) and 6 (37.5%) patients, respectively. The most frequent histological types were the lymphoplasmocytic cytoid (4/25.0%) and centroblastic (4/25.0%). Ten patients (62.5%) received adjuvant treatment (chemotherapy and/or radiotherapy). Nine patients (56.2%), all in stage IE, reached a survival greater than 5 years and of these eight (50.0.%) had received adjuvant therapy. Two (12.5%) patients with stage IIE1 presented peritoneal relapse and died 3.0 years and 3.5 years after their respective operations. The mean overall survival was 42,5 months. Conclusions -Among the patients with primary early-stage gastric lymphoma (IE and IIE1), the gastric resection enabled an accurate clinicopathological staging, in addition to obtaining sufficient material for histopathological study and extirpation of the lesion. Furthermore, for patients with stage IE disease, the gastric resection combined with adjuvant therapy was associated with a greater than 5-year survival. Until prospective randomized studies are realized in order to evaluate the real efficacy of the different types of treatment for primary early-stage gastric lymphoma, management approaches should be individually tailored. HEADINGS -Lymphoma. Non-Hodgkin's lymphoma. Gastric neoplasms. Prognostic factors. Survival. lymphomas, mucosa-associated lymphoid tissue (MALT) and low-grade lymphomas (12,16,27,28,31) . Due to the relative rarity of the tumor, few centers have accumulated an adequate number of pat...

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“…Although substantial progress has been achieved in the diagnosis and treatment of gastric lymphomas in recent years [2,3] primary intestinal lymphomas are not well characterized, and standardized concepts for their clinical diagnosis and management are absent. The aim of this observation is to shed light on NHL of the small bowel, its clinical and radiological diagnosis and its treatment especially in forms revealed by intussusceptions in adults.…”

Section: Introductionmentioning

confidence: 99%

Non-Hodgkin’s lymphoma revealed by an ilio-colic intussusception in a Moroccan patient: a case report

Hassani¹,

Bouhaddouti²,

Ousadden³

et al. 2010

Pan Afr Med Jrnl

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Intussusceptions are rare but well-known causes of the small bowel obstruction in adults and an underlying cause is present in the majority of cases. Lymphoma's involvement of the ileum is one of the rare causes of intussusception. CT is a sensitive examination that diagnoses intussusceptions and provides an excellent preoperative evaluation including possible extension and dissemination especially in intestinal lymphomas. The treatment is almost always surgical and the pathological study is needed for diagnostic confirmation. Authors present an unusual case of intestinal intussusception due to lymphoma of the terminal part of the ileum in a 49-year-old man. Computed tomography confirmed the diagnosis of intussusception and non-Hodgkin's lymphoma of B-cell was diagnosed by histological examination after surgical treatment. Primary intestinal lymphomas differ from gastric lymphomas in clinical features, treatment, and prognosis. They are not well characterized and the standardized concepts for their clinical diagnosis and management are absent. The aim of this rare observation is to shed light on NHL of the small bowel, its clinical and radiological diagnosis and its treatment especially in forms revealed by intussusceptions in adults.

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Chemotherapy for the treatment of patients with primary high grade gastric B-cell lymphoma of modified Ann Arbor stages IE and IIE

Cited by 45 publications

References 16 publications

Primary gastric lymphoma

Primary gastric lymphoma

Curative resection plus adjuvant chemotherapy for early stage primary gastric non-Hodgkin's lymphoma: a retrospective study with emphasis on prognostic factors and treatment outcome

Non-Hodgkin’s lymphoma revealed by an ilio-colic intussusception in a Moroccan patient: a case report

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