OBJECTIVE: This article reviews the pathogenesis, diagnosis, and treatment of patients with primary gastric lymphoma, with special attention to the changing role of surgery. SUMMARY BACKGROUND DATA: Primary gastric lymphomas are non-Hodgkin lymphomas that originate in the stomach and are divided into low-grade (or indolent) and high-grade (or aggressive) types. Low-grade lesions nearly always arise from mucosa-associated lymphoid tissue (MALT) secondary to chronic Helicobacter pylori (H. pylori) infection and disseminate slowly. High-grade lesions may arise from a low grade-MALT component or arise de novo and can spread to lymph nodes, adjacent organs and tissues, or distant sites. METHODS: A review of the relevant English-language articles was performed on the basis of a MEDLINE search from January 1984 to August 2003. RESULTS: About 40% of gastric lymphomas are low-grade, and nearly all these low-grade lesions are classified as MALT lymphomas. For low-grade MALT lymphomas confined to the gastric wall and without certain negative prognostic factors, H. pylori eradication is highly successful in causing lymphoma regression. More advanced low-grade lymphomas or those that do not regress with antibiotic therapy can be treated with combinations of H. pylori eradication, radiation therapy, and chemotherapy. Nearly 60% of gastric lymphomas are high-grade lesions with or without a low-grade MALT component. These lymphomas can be treated with chemotherapy and radiation therapy according to the extent of disease. Surgery for gastric lymphoma is now often reserved for patients with localized, residual disease after nonsurgical therapy or for rare patients with complications. CONCLUSION: The treatment of gastric lymphoma continues to evolve, and surgical resection is now uncommonly a part of the initial management strategy.
OBJECTIVE: This article reviews the pathogenesis, diagnosis, and treatment of patients with primary gastric lymphoma, with special attention to the changing role of surgery. SUMMARY BACKGROUND DATA: Primary gastric lymphomas are non-Hodgkin lymphomas that originate in the stomach and are divided into low-grade (or indolent) and high-grade (or aggressive) types. Low-grade lesions nearly always arise from mucosa-associated lymphoid tissue (MALT) secondary to chronic Helicobacter pylori (H. pylori) infection and disseminate slowly. High-grade lesions may arise from a low grade-MALT component or arise de novo and can spread to lymph nodes, adjacent organs and tissues, or distant sites. METHODS: A review of the relevant English-language articles was performed on the basis of a MEDLINE search from January 1984 to August 2003. RESULTS: About 40% of gastric lymphomas are low-grade, and nearly all these low-grade lesions are classified as MALT lymphomas. For low-grade MALT lymphomas confined to the gastric wall and without certain negative prognostic factors, H. pylori eradication is highly successful in causing lymphoma regression. More advanced low-grade lymphomas or those that do not regress with antibiotic therapy can be treated with combinations of H. pylori eradication, radiation therapy, and chemotherapy. Nearly 60% of gastric lymphomas are high-grade lesions with or without a low-grade MALT component. These lymphomas can be treated with chemotherapy and radiation therapy according to the extent of disease. Surgery for gastric lymphoma is now often reserved for patients with localized, residual disease after nonsurgical therapy or for rare patients with complications. CONCLUSION: The treatment of gastric lymphoma continues to evolve, and surgical resection is now uncommonly a part of the initial management strategy.
Authors: M Sackmann; A Morgner; B Rudolph; A Neubauer; C Thiede; H Schulz; W Kraemer; G Boersch; P Rohde; E Seifert; M Stolte; E Bayerdoerffer Journal: Gastroenterology Date: 1997-10 Impact factor: 22.682
Authors: G Pinotti; E Zucca; E Roggero; A Pascarella; F Bertoni; A Savio; E Savio; C Capella; E Pedrinis; P Saletti; E Morandi; G Santandrea; F Cavalli Journal: Leuk Lymphoma Date: 1997-08
Authors: Y Kodera; Y Yamamura; S Nakamura; Y Shimizu; A Torii; T Hirai; K Yasui; T Morimoto; T Kato; T Kito Journal: Ann Surg Date: 1998-01 Impact factor: 12.969
Authors: G Steinbach; R Ford; G Glober; D Sample; F B Hagemeister; P M Lynch; P W McLaughlin; M A Rodriguez; J E Romaguera; A H Sarris; A Younes; R Luthra; J T Manning; C M Johnson; S Lahoti; Y Shen; J E Lee; R J Winn; R M Genta; D Y Graham; F F Cabanillas Journal: Ann Intern Med Date: 1999-07-20 Impact factor: 25.391
Authors: Gabriele Reinartz; Regina P Pyra; Georg Lenz; Rüdiger Liersch; Georg Stüben; Oliver Micke; Kay Willborn; Clemens F Hess; Andreas Probst; Rainer Fietkau; Ralf Jany; Jürgen Schultze; Christian Rübe; Carsten Hirt; Wolfgang Fischbach; Martin Bentz; Severin Daum; Christiane Pott; Markus Tiemann; Peter Möller; Andreas Neubauer; Martin Wilhelm; Normann Willich; Wolfgang E Berdel; Hans T Eich Journal: Strahlenther Onkol Date: 2019-03-11 Impact factor: 3.621
Authors: Barry W Hancock; Wendi Qian; David Linch; Jean-Charles Delchier; Paul Smith; Ira Jakupovic; Cathy Burton; Robert Souhami; Andrew Wotherspoon; Christiane Copie-Bergman; Carlo Capella; Catherine Traulle; Michael Levy; Sergio Cortelazzo; Andres J M Ferreri; Achille Ambrosetti; Graziella Pinotti; Giovanni Martinelli; Umberto Vitolo; Franco Cavalli; Christian Gisselbrecht; Emanuele Zucca Journal: Br J Haematol Date: 2008-11-22 Impact factor: 6.998