CLINICAL-FEATURES, TREATMENT AND OUTCOME IN A SERIES OF 93 PATIENTS WITH LOW-GRADE GASTRIC MALT LYMPHOMA

The purpose of this paper is to report the clinical characteristics an d treatment outcome following different therapeutic approaches in a la rge series of patients with primary low-grade MALT lymphoma of the sto mach. A total of ninety-three patients (median age 63 years) were revi ewed. The patients were treated by different modalities (local treatme nt alone, combined treatment, chemotherapy, antibiotics alone); seven patients refused any treatment. The antibiotic-treated group of patien ts was prospectively followed with regular endoscopic biopsies, and th eir responses were histologically evaluated. The 5-years projected ove rall survival is 82% (95% C.I.; 67%-91%) in the series as a whole, Sec ond tumors were observed in 21.5% of the patients in this series (95% CI 14%v to 31%). There was no apparent difference in overall survival and event-free survival between patients who received different treatm ents. In the antibiotic-treated group histologic regression of MALT ly mphoma was documented in 67% of patients (95% CI 51% to 80%). In concl usion the indolent nature of the disease justifies a conservative appr oach. The use of antibiotics as first-line therapy may avert or at lea st postpone the indication for surgical resection in the majority of p atients.