Clinical features, treatment and outcomes of colorectal mucosa-associated lymphoid tissue (MALT) lymphoma: literature reviews published in English between 1993 and 2017
Authors Won JH, Kim SM, Kim JW, Park JH, Kim JY
Received 2 May 2019
Accepted for publication 13 August 2019
Published 20 September 2019 Volume 2019:11 Pages 8577—8587
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Nicola Ludin
Peer reviewer comments 2
Editor who approved publication: Professor Rudolph Navari
Jae Hee Won,1 Sung Min Kim,1 Jong Wan Kim,1 Jun Ho Park,2 Jeong Yeon Kim1
1Department of Surgery, Dongtan Sacred Hospital, Hallym University College of Medicine, KyungKee, Korea; 2Department of Surgery, Kangdong Sacred Hospital, Hallym University College of Medicine, KyungKee, Korea
Correspondence: Jeong Yeon Kim
Department of Surgery, Dongtan Sacred Hospital, Hallym University College of Medicine, Seokwoodong 42, kyungkee 18450, Republic of Korea
Tel +82 031 8 086 2430
Fax +82 031 8 086 2029
Background: Colorectal mucosa-associated lymphoid tissue (MALT) lymphoma (cMALToma) is rare and comprises only 2.5% of the MALT lymphomas. Its etiology and treatment have not been well established. The aim of this systematic literature review was to try to characterize cMALToma and analyze the risk factors for treatment failure with various therapeutic strategies.
Methods: We retrospectively reviewed 50 case reports from 1993 to 2017 through a PubMed search of English medical literature, describing cMALToma. We included 67 patients from previous case reports and we added 6 patients treated for cMALToma in our multicenter institutes. Risk factor analysis was done for treatment failure, defined as remission failure and recurrence.
Results: Of 73 patients diagnosed with cMALToma, tumors were located in 54 patients (74.0%) in the rectum, in 10 patients (13.6%) in the right colon, in 3 patients (4.1%) in the transverse colon, and in 6 patients (8.2%) in the sigmoid colon. In first-line treatment, patients achieved complete remission (CR) with surgery (18/19 cases), local resection (18/19 cases), chemotherapy (12/13 cases), radiation therapy (4/5 cases), antibiotics therapy including Helicobacter pylori eradication (12/15 cases), and no treatment (1/2 cases). Among these, eight cases (10.9%) needed second-line treatment, and there was overall remission failure in 3 cases (4.1%). Of the remaining 70 patients with CR, the tumor recurred in 5 patients (6.8%). The multivariable analysis showed that male sex, multiple tumors, and first-line treatment failure were significantly related to treatment failure (p=0.03, p=0.05, p=0.03, respectively).
Conclusion: CR of primary cMALToma was achieved using various therapeutic strategies. First-line treatment failure and multiple tumors were associated with treatment failure, although the numbers of cases that failed are too small to draw definitive conclusions.
Keywords: MALT-associated lymphoma, colon, rectum, prognosis
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