Role of Surgery in Patients with Stage IE Primary Thyroid MALT Lymphoma Staged by a Modified Classification System: The Tokyo Classification.

Autor: Saito Y; Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan., Watanabe N; Department of Internal Medicine, Ito Hospital, Tokyo 150-8308, Japan., Suzuki N; Department of Internal Medicine, Ito Hospital, Tokyo 150-8308, Japan., Saito N; Department of Radiology, Juntendo University, Tokyo 113-8431, Japan., Narimatsu H; Cancer Prevention and Control Division, Kanagawa Cancer Center, Yokohama 241-8515, Japan.; Graduate School of Health Innovation, Kanagawa University of Human Services, Kawasaki 238-8522, Japan., Takami H; Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan., Kameyama K; Department of Pathology, Showa University Northern Yokohama Hospital, Yokohama 224-8503, Japan., Yoshioka K; Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan., Masaki C; Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan., Akaishi J; Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan., Hames KY; Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan., Matsumoto M; Department of Internal Medicine, Ito Hospital, Tokyo 150-8308, Japan., Fukushita M; Department of Internal Medicine, Ito Hospital, Tokyo 150-8308, Japan., Yoshihara A; Department of Internal Medicine, Ito Hospital, Tokyo 150-8308, Japan., Okamura R; Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan., Tomoda C; Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan., Suzuki A; Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan., Matsuzu K; Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan., Kitagawa W; Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan., Nagahama M; Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan., Noh JY; Department of Internal Medicine, Ito Hospital, Tokyo 150-8308, Japan., Sugino K; Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan., Ito K; Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2023 Feb 24; Vol. 15 (5). Date of Electronic Publication: 2023 Feb 24.
DOI: 10.3390/cancers15051451
Abstrakt: Purposes: To establish the appropriate staging system and assess the role of curative thyroidectomy alone (Surgery) vs. involved-site radiation therapy after open biopsy (OB-ISRT) in stage IE mucosa-associated lymphoid tissue (MALT) lymphoma.
Methods: We examined the Tokyo Classification as a modified classification. This retrospective cohort study included 256 patients with thyroid MALT lymphoma; 137 underwent standard therapy (i.e., OB-ISRT) and were enrolled for the Tokyo classification. Sixty stage IE patients with the same diagnosis were examined to compare Surgery with OB-ISRT.
Results: Overall survival ( p = 0.0092) and relapse-free survival (0.00113) were significantly better in stage IE vs. stage IIE under the Tokyo classification. No OB-ISRT and Surgery patients died, but three OB-ISRT patients relapsed. The incidence of permanent complications was 28% in OB-ISRT (mainly dry mouth) and 0% in Surgery ( p = 0.027). The number of painkiller prescription days was significantly greater in OB-ISRT ( p < 0.001). During follow-up, the rate of the new appearance/change of the low-density area in the thyroid gland was significantly higher in OB-ISRT ( p = 0.031).
Conclusions: The Tokyo classification allows an appropriate discrimination between stages IE and IIE MALT lymphoma. Surgery can provide a good prognosis in stage IE cases; it also avoids complications, shortens painful periods during treatment, and simplifies ultrasound follow-up.
Databáze: MEDLINE
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