Retrospective comparison of the effectiveness of various treatment modalities of extragastric MALT lymphoma: a single-center analysis
| Autor: | Julia Fischbach, Leonhard Müllauer, Marius E. Mayerhoefer, Markus Raderer, Barbara Kiesewetter, Stefan Wöhrer, Julius Lukas, Marlene Troch |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Lung Neoplasms medicine.medical_treatment Antineoplastic Agents Kaplan-Meier Estimate Single Center Gastroenterology Disease-Free Survival Pharmacotherapy Interquartile range hemic and lymphatic diseases Internal medicine Humans Medicine Thyroid Neoplasms Aged Retrospective Studies Aged 80 and over business.industry Surrogate endpoint Eye Neoplasms MALT lymphoma Lymphoma B-Cell Marginal Zone Hematology General Medicine Middle Aged Salivary Gland Neoplasms medicine.disease Combined Modality Therapy Anti-Bacterial Agents Lymphoma Surgery Radiation therapy Treatment Outcome Organ Specificity Austria Disease Progression Immunotherapy Colorectal Neoplasms business Progressive disease |
| Zdroj: | Annals of Hematology. 93:1287-1295 |
| ISSN: | 1432-0584 0939-5555 |
| DOI: | 10.1007/s00277-014-2042-z |
| Popis: | We have performed a retrospective analysis of all patients with extragastric mucosa-associated lymphoid tissue (MALT) lymphoma treated at our institution to compare the efficacy of first-line therapeutic modalities including surgery, radiation, systemic therapy, and antibiotics. One hundred eighty-five patients with extragastric MALT lymphoma with a median age of 63 (interquartile range (IQR) 50-74) years and a median follow-up time of 49 (IQR 18-103) months were retrospectively analyzed. Time to progression and time to next therapy were used as surrogate endpoints for efficacy. Patients having either surgery (100 %), chemo/immunotherapy (85.5 %), or radiation (80 %) had significantly (p = 0.01) higher response rates than patients treated with antibiotics (33.3 %). Patients who were irradiated had significantly more progressive disease, but also the longest follow-up time. Stage, elevated LDH, anemia, elevated beta-2 microglobulin, plasmacytic differentiation, monoclonal gammopathy, or autoimmune disease did not influence the rate of disease progression nor did complete remission or partial remission from initial therapy influence time to and rate of progression. There was no significant difference in the median time to progression (p = 0.141), but the estimated time to progression (p = 0.023) as well as the estimated time to next therapy (p = 0.021) was significantly different among the various cohorts favoring surgery, chemo/immunotherapy, and radiation. Our results suggest extragastric MALT lymphoma as a potential systemic disease irrespective of initial stage. Radiation, surgery, and chemo/immunotherapy seem to be equally effective in achieving remissions and prolonged progression free survivals, but a curative potential is questionable. Localized MALT lymphomas affecting the thyroid gland or the lungs have excellent long-term progression-free survivals with surgical treatment only. |
| Databáze: | OpenAIRE |
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