Clinical outcome andprognostic factors of primary gastric mucosa-associated lymphoid tissue lymphoma: aretrospective analysis of 77 cases

：Objective To analyze theclinical results and prognostic factors of patients with early-stage primary gastricmucosa-associated lymphoid tissue(MALT) lymphoma. Methods Seventy-seven pa-tients withprimary gastric MALT lymphoma treated from 1985 to 2006 were retrospectively analyzed. Allpa-tients were pathologically confirmed as MALT lymphoma in stage Ⅰ ,Ⅱ and Ⅱ_E (by modified Blackedgestaging system). Thirty-seven patients had stage Ⅰ disease,23 stage Ⅱ and 17 stage Ⅱ_E.Sixty patients un-derwent surgical resection and 17 received non-surgical treatment.Survival rates were calculated by the Kap-lan-Meier analysis with the Logrank test.Results With a median follow up of 57 months for the surviving patients(ranging from 1 to198 months for all patients), the 5-year overall survival rate, disease-free survivalrate,loco-regional control rate and distant metastasis free survival rate were 74%,70%,76% and 87% ,re-spectively. In univariate analysis, clinical stage was significantlyassociated with overall survival. Patients with stage Ⅰ or Ⅱ disease had a better overallsurvival than those with stage Ⅱ_E (P = 0.01). Tumor size andsurgical resection were significantly associated with disease-free survival. Patients withprimary tumor 8 cm or less in diameter had better disease-free survival than those withprimary tumor more than 8 cm in diameter(P =0.03). Patients who underwent completeresection had better disease-free survival than those who under-went incomplete resectionor no surgery (P =0.02). Clinical stage, tumor size and surgical resection weresignificantly associated with loco-regional control. Patients with stage Ⅰ or Ⅱ disease had betterloco-regional control than those with stage Ⅱ_E (P = 0. 03). Patients withprimary tumor 8 cm or less in diameter had better loco-regional control than those withprimary tumor more than 8 cm in diameter(P =0.01). Patients who un-derwent completeresection had better loco-regional control than those who underwent incomplete resectionor no surgery(P=0.03). Patients with stage Ⅰand Ⅱ disease treated with surgery had more local recurrence, andpatients treated without surgery tended to recur systematically. Patients with stageⅡ_E disease tended torecur locally in spite of surgery or not. Conclusions The efficacy of surgical andnon-surgical treatment for primary gastric MALT lymphoma are similar. Surgical resectionis no longer a necessary approach in the primary treatment. Clinical stage is an importantprognostic factor for primary gastric MALT lymphoma. Key words: Lymphoma; gastric mucosa-associated lymphoid tissue/surgery; Lymphoma; gastric mucosa-associated lymphoid tissue/radio-chemotherapy; Prognosis