ABSTRACT
BACKGROUND: Non-Hodgkin's lymphoma (NHL) originating in mucosa-associated lymphoid tissue (MALT) is supposed to have different clinical behavior from lymph node NHL. To test this hypothesis, the authors compared data of gastric NHL patients with lymph node NHL patients in a population-based registry for differences in clinical presentation and prognosis. METHODS: Data from 1981-1989 on patients with primary gastric NHL (n = 109) and patients with primary lymph node NHL (n = 658) were retrieved from a Dutch population-based NHL registry. Patients were compared for stage distribution, involved sites, and survival. The prognostic value of grading lymphomas according to the malignancy grades of the Working Formulation for Clinical Usage was compared with the value of grading MALT NHLs as either low grade or high grade malignancies. RESULTS: Patients with gastric NHL presented more often with localized disease. Stage IV patients had a higher rate of dissemination to other non-lymph node sites but less frequent localization in the bone marrow. The restricted pattern of dissemination was reflected in a significantly lower recurrence rate for gastric NHL. Gastric NHL patients had significantly better disease free survival than lymph node NHL patients (80% and 44% at 5 years, respectively; P < 0.001). In contrast, overall survival did not significantly differ between the two groups, and it appeared to depend on disease stage. Grading MALT lymphoma as either low grade (26%) or high grade (70%) malignancies did not provide better prognostic information than grading according to the Working Formulation for Clinical Usage (low 8%, intermediate 75%, high 9%). CONCLUSIONS: Primary gastric NHL shows a restricted dissemination pattern, which gives support to the MALT lymphoma concept. Although this might explain the superior disease free survival observed for gastric NHL patients, it does not translate into better overall survival for these patients.
Subject(s)
Lymphoma, Non-Hodgkin/pathology , Stomach Neoplasms/pathology , Adult , Aged , Aged, 80 and over , Female , Humans , Lymph Nodes/pathology , Lymphoma, B-Cell, Marginal Zone/pathology , Male , Middle Aged , Neoplasm Staging , Prognosis , Recurrence , RegistriesABSTRACT
Serum TPS, CA 15-3 and CEA levels were measured in 31 women when progressive metastatic disease was established according to UICC criteria. A method was developed to apply these serum tumor markers in order to measure the short-term effect of the treatment. Using strict criteria, whereby an increase of the markers of more than 25% indicated progressive disease and a decrease of more than 50% indicated a positive effect of the treatment, TPS (which measures tumoral activity) was shown to be a more sensitive and earlier marker for measuring treatment response than CA 15-3 and CEA (which measure tumor mass).
Subject(s)
Biomarkers, Tumor/analysis , Breast Neoplasms/therapy , Antigens, Tumor-Associated, Carbohydrate/analysis , Breast Neoplasms/diagnosis , Breast Neoplasms/pathology , Carcinoembryonic Antigen/analysis , Female , Follow-Up Studies , Humans , Neoplasm Metastasis , Peptides/analysis , Retrospective Studies , Tissue Polypeptide AntigenABSTRACT
A 26 year old man with a nine year history of adult onset Still's disease (AOSD) developed sensorineural hearing loss during an exacerbation of his disease. This complication has not previously been described in association with adult onset Still's disease. He responded favourably to steroid treatment.
