Back to Search
Start Over
Should All Patients With Stage IE Gastric Mucosa-Associated Lymphoid Tissue Lymphoma Receive Antibiotic Eradication Therapy for Helicobacter pylori ?
- Source :
-
JCO oncology practice [JCO Oncol Pract] 2024 Aug; Vol. 20 (8), pp. 1103-1108. Date of Electronic Publication: 2024 May 07. - Publication Year :
- 2024
-
Abstract
- Purpose: H. pylori eradication therapy (HPE) can lead to tumor regression in H. pylori -positive (HPP) gastric mucosa-associated lymphoid tissue (MALT) lymphoma. However, some patients do not have detectable H. pylori (HP) infection ( H. pylori -negative [HPN]) and the guidelines differ in their initial approach to HPN patients. The National Comprehensive Cancer Network (NCCN) recommends proceeding to radiation therapy, whereas European Society for Medical Oncology suggests HPE for every patient, even those who are HPN. To address this issue, we evaluated the effectiveness of HPE in limited-stage gastric MALT lymphoma.<br />Materials and Methods: We retrospectively reviewed patients newly diagnosed with stage IE gastric MALT lymphoma between January 2002 and December 2022. The primary outcome was the complete remission (CR) rate defined as no macroscopic findings of lymphoma and negative gastric biopsy at the follow-up gastric endoscopy.<br />Results: Fifty-two patients were reviewed, and HP infection was detected in 19 (36.5%) patients-14 by immunostaining, three by serology, and one each by stool antigen and urea breath test. All 19 HPP and eight of the 33 HPN patients received HPE treatment. The CR rate was 63% (12/19) in HPP patients and 13% (1/8) in HPN patients ( P = .033). After a median follow-up of 89.7 months, only two of the 12 HPP patients achieving CR have relapsed; the one HPN patient who received HPE remains in CR at 12+ months.<br />Conclusion: For limited-stage HPP gastric MALT lymphoma, HPE is an effective and durable first-line treatment and should be used. For HPN patients, the CR rate with HPE is very low in our experience and is thus in support of the NCCN guideline.
- Subjects :
- Humans
Male
Female
Middle Aged
Retrospective Studies
Aged
Adult
Neoplasm Staging
Aged, 80 and over
Lymphoma, B-Cell, Marginal Zone drug therapy
Lymphoma, B-Cell, Marginal Zone microbiology
Helicobacter pylori drug effects
Helicobacter pylori pathogenicity
Anti-Bacterial Agents therapeutic use
Helicobacter Infections drug therapy
Helicobacter Infections microbiology
Helicobacter Infections complications
Stomach Neoplasms drug therapy
Stomach Neoplasms microbiology
Stomach Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 2688-1535
- Volume :
- 20
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- JCO oncology practice
- Publication Type :
- Academic Journal
- Accession number :
- 38713887
- Full Text :
- https://doi.org/10.1200/OP.23.00624