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Clinical characteristics and prognostic factors of primary gastric lymphoma: A retrospective study with 165 cases.
- Source :
-
Medicine [Medicine (Baltimore)] 2016 Aug; Vol. 95 (31), pp. e4250. - Publication Year :
- 2016
-
Abstract
- Primary gastric lymphoma (PGL) is the most common extranodal non-Hodgkin lymphoma. This retrospective study aimed to analyze the clinical characteristics, prognostic factors, and roles of different treatment modalities in patients with PGL.From January 2003 to November 2014, 165 patients who were diagnosed with PGL at West China Hospital were enrolled in this study. The clinical features, treatment, and follow-up information were analyzed.In this study, diffuse large B-cell lymphoma (DLBCL) (108, 65.5%) and mucosa-associated lymphoid tissue (MALT) lymphoma (52, 31.5%) were two predominant histological subtypes. One-year and 5-year overall survival (OS) rates of all patients were 95.2% and 79.5%, respectively; in whom 110 (66.7%) underwent surgery, 110 (66.7%) received chemotherapy, 12 (7.3%) received radiotherapy, and 10 (6.1%) received Helicobacter pylori eradication. And 75 patients (45.5%) were treated with at least 2 different types of therapies. Elevated lactic dehydrogenase (LDH) levels, poor performance status (PS), advanced stage, International Prognostic Index (IPI) score ≥3, conservative treatment, and high-grade histological subtype were associated with worse prognosis in univariate analysis. Cox regression analysis showed that LDH levels, PS, staging, and histological subtype were independent predictors of survival outcomes. In the DLBCL type, 5-year OS was significantly better in the surgically treated group (80.1%) than that of patients conservatively treated (49.8%) (P = 0.001). Surgical treatment had almost no impact on OS in the MALT type than conservative treatment (P = 0.597). The proportion of patients received conservative treatment increased from 4.5% in period 1 to 51.7% in period 4.High LDH levels, poor PS, advanced staging, and malignant pathological type at diagnosis are significantly associated with poor OS. Our data suggest that surgery is superior in prognosis over conservative treatment in the DLBCL type, but not in the MALT type. Recently, conservative treatment is becoming more preferred approach in patients with PGL.
- Subjects :
- Adult
Aged
Antineoplastic Combined Chemotherapy Protocols administration & dosage
Biopsy, Needle
Cohort Studies
Combined Modality Therapy
Disease-Free Survival
Female
Humans
Immunohistochemistry
Lymphoma, B-Cell, Marginal Zone mortality
Lymphoma, B-Cell, Marginal Zone pathology
Lymphoma, B-Cell, Marginal Zone therapy
Lymphoma, Large B-Cell, Diffuse therapy
Lymphoma, Non-Hodgkin therapy
Male
Middle Aged
Neoplasm Staging
Prognosis
Radiotherapy, Adjuvant
Retrospective Studies
Risk Assessment
Stomach Neoplasms therapy
Survival Analysis
Young Adult
Cause of Death
Lymphoma, Large B-Cell, Diffuse mortality
Lymphoma, Large B-Cell, Diffuse pathology
Lymphoma, Non-Hodgkin mortality
Lymphoma, Non-Hodgkin pathology
Stomach Neoplasms mortality
Stomach Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1536-5964
- Volume :
- 95
- Issue :
- 31
- Database :
- MEDLINE
- Journal :
- Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 27495029
- Full Text :
- https://doi.org/10.1097/MD.0000000000004250