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. 2024 Oct;24(4):406-419.
doi: 10.5230/jgc.2024.24.e36.

Long-term Outcomes and Prognostic Factors of Gastric MALT Lymphoma

Jae Yeon Sim  1 , Hyun Soo Chung  2 , Sang Gyun Kim  1 , Soo Jeong Cho  1 , Bo Kyung Kim  1 , Jun Shik Hong  1 , In Ho Kim  1
Affiliations

Long-term Outcomes and Prognostic Factors of Gastric MALT Lymphoma

Jae Yeon Sim et al. J Gastric Cancer. 2024 Oct.

Abstract

Purpose: This study aimed to evaluate the long-term prognosis of patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma, including overall survival (OS), remission, and factors associated with an aggressive disease course.

Materials and methods: Medical records of 153 patients diagnosed with gastric MALT lymphoma between 2013 and 2020 were retrospectively reviewed. Patients experiencing relapse, progression, high-grade transformation, or residual diseasewere included in the aggressive group and were compared with those in the indolent group. Additionally, the endoscopic findings of Helicobacter pylori-negative patients were reviewed.

Results: Patient characteristics were as follows: mean age (56.9±11.2 years), sex (male, 51.0%), H. pylori infection (positive, 79.7%), endoscopic location (distal, 89.5%), endoscopic feature (superficial, 89.5%), clinical stage (stage I, 92.8%), invasion depth by endoscopic ultrasound (mucosa, n=115, 75.7%), and bone marrow result (no involvement, n=77, 100.0%). The median follow-up period was 59 months (mean, 61; range, 36-124) and the continuous remission period (n=149) was 51 months (mean, 50; range, 3-112). The 5-year survival rate was 97.7% while the 5-year continuous remission was 88.3%. Factors associated with the patients in the aggressive group were old age, sex(male), and clinical stage II or higher. H. pylori-negative patients' endoscopy revealed a high incidence of atrophic gastritis in the antrum.

Conclusions: The long-term prognosis of gastric MALT lymphoma appears indolent and is indicated by the 5-year OS and continuous remission rates. Aggressive disease courses are associated with old age, sex (male), and clinical stage II or higher, but are not related to OS.

Keywords: Helicobacter pylori; Lymphoma, B-cell; Marginal zone; Survival analysis.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. The clinical course of patients who were H. pylori-positive.
RTx = radiation therapy; CTx, chemotherapy; ChR = complete histologic response; pMRD = probable minimal residual disease; rRD = responding residual disease; NC = no change; CCR = continuous complete remission; CR = complete remission; R = relapse; H = high-grade transformation; R* = residual; P = progression.
Fig. 2
Fig. 2. The clinical course of patients who were H. pylori-negative.
RTx = radiation therapy; CTx = chemotherapy; ChR = complete histologic response; pMRD = probable minimal residual disease; rRD = responding residual disease; NC = no change; CCR = continuous complete remission; CR = complete remission; R = relapse; H = high-grade transformation; R* = residual; P = progression.
Fig. 3
Fig. 3. OS of 153 patients (left) and comparison between patients in the indolent and aggressive group (right).
OS = overall survival.
Fig. 4
Fig. 4. Kaplan-Meier curve analysis: continuous remission rate of 149 patients.
Fig. 5
Fig. 5. Endoscopic findings of H. pylori-negative gastric MALT lymphoma in patients. (A) Granular type. (B) Erosive type. (C) Atrophic type. (D) Ulcerative type. (E) Fold hypertrophy type. (F) Polypoid type.
MALT = mucosa-associated lymphoid tissue.
See this image and copyright information in PMC

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