Clin Endosc.  2017 Jan;50(1):51-57. 10.5946/ce.2016.015.

Correlation of Endoscopic Findings of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma with Recurrence after Complete Remission

• Lee CM
• Lee DH
• Ahn BK
• Hwang JJ
• Yoon H
• Park YS
• Shin CM
• Kim N

• KMID: 2383490
• DOI: http://doi.org/10.5946/ce.2016.015

Abstract

BACKGROUND/AIMS
In gastric mucosa-associated lymphoid tissue (MALT) lymphoma, the clinical significance of various endoscopic findings has not yet been determined. This study aimed to compare the time to complete remission (CR) and relapse-free survival (RFS) in gastric MALT lymphoma based on endoscopic findings.
METHODS
In this single-center retrospective cohort study, the medical records of 122 consecutive adult patients with gastric MALT lymphoma were collected over a period of 12 years. CR was defined by the absence of macroscopic or microscopic features of lymphoma on two subsequent follow-ups. Relapse was clinically defined by a positive endoscopic biopsy after CR.
RESULTS
The median time to CR did not differ significantly between treatment methods. However, it was significantly longer in the group with polypoid endoscopic appearance than in the groups with diffuse infiltration or ulceration (7.83, 3.43, and 3.10 months, respectively; p=0.003). Six patients relapsed after CR. Kaplan-Meier analysis showed that RFS differed significantly between groups based on Ann Arbor staging, treatment methods, and initial endoscopic findings.
CONCLUSIONS
In gastric MALT lymphoma, the endoscopically defined polypoid type was characterized by a longer duration to CR, with a higher likelihood of recurrence, compared to the endoscopically defined diffuse infiltration or ulceration types.

Keyword

Endoscopy; Familial primary gastric lymphoma; Lymphoma, B-cell, marginal zone; Recurrence

MeSH Terms

Adult
Biopsy
Cohort Studies
Endoscopy
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Lymphoid Tissue
Lymphoma
Lymphoma, B-Cell, Marginal Zone*
Medical Records
Recurrence*
Retrospective Studies
Ulcer

Figure

• 

  Fig. 1. Endoscopic findings on gastric mucosa-associated lymphoid tissue lymphoma. (A) Diffuse infiltrative type with multiple erosions and hyperemic patches. (B) Ulcerative type. (C) Polypoid type with focal fold thickening.

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  Fig. 2. Kaplan-Meier analysis of relapse-free survival (RFS). (A) Kaplan-Meier estimates of RFS based on the Ann Arbor stage. Blue, green, and yellow curves represent stages IE, IIE, and IIE/IVE, respectively. (B) Kaplan-Meier estimates of RFS based on the treatment type. Blue, green, and yellow curves represent Helicobacter pylori (HP) eradication, radiotherapy, and chemotherapy, respectively. (C) Kaplan-Meier estimates of RFS based on endoscopic appearance. Blue, green, and yellow curves represent diffuse infiltration, ulceration, and polypoid types, respectively.

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