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Open Access Research article

Primary gastric non-Hodgkin's lymphoma in Chinese patients: clinical characteristics and prognostic factors

JiaJia Huang12, WenQi Jiang12, RuiHua Xu12, HuiQiang Huang12, Yue Lv13, ZhongJun Xia13, XiaoFei Sun14, ZhongZhen Guan12, TongYu Lin12* and ZhiMing Li12*

Author Affiliations

1 State Key Laboratory of Oncology in Southern China, Sun Yat-sen University, Guangzhou, Guangdong, China

2 Department of Medical Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, China

3 Department of Hematology & Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, China

4 Department of Pediatic Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, China

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BMC Cancer 2010, 10:358  doi:10.1186/1471-2407-10-358

Published: 6 July 2010

Abstract

Background

Optimal management and outcome of primary gastric lymphoma (PGL) have not been well defined in the rituximab era. This study aimed to analyze the clinical characteristics, prognostic factors, and roles of different treatment modalities in Chinese patients with PGL.

Methods

The clinicopathological features of 83 Chinese patients with PGL were retrospectively reviewed. Staging was performed according to the Lugano staging system for gastrointestinal non-Hodgkin's lymphoma.

Results

The predominant pathologic subtype among Chinese patients with PGL in our study was diffuse large B cell lymphoma (DLBCL), followed by mucosa-associated lymphoid tissue (MALT) lymphoma. Among the 57 patients with gastric DLBCL, 20 patients (35.1%) were classified as the germinal center B cell-like (GCB) subtype and 37 patients (64.9%) as the non-GCB subtype. The 83 patients had a five-year overall survival (OS) and event-free survival (EFS) of 52% and 59%, respectively. Cox regression analysis showed that stage-modified international prognostic index (IPI) and performance status (PS) were independent predictors of survival. In the 67 B-cell lymphoma patients who received chemotherapy, 36 patients treated with rituximab (at least 3 cycles) had a mean OS of 72 months (95% CI 62-81) versus 62 months (95% CI 47-76) for patients without rituximab treatment (P = 0.021).

Conclusion

The proportion of Chinese gastric DLBCL cases with non-GCB subtype was higher than the GCB subtype. Stage-modified IPI and PS were effective prognostic factors in Chinese patients with PGL. Our data suggested that primary gastric B-cell lymphoma might have an improved outcome with rituximab in addition to chemotherapy. More studies are necessary, preferentially large prospective randomized clinical trials to obtain more information on the impact of the rituximab in the primary gastric B-cell lymphoma.