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The Role of Abdominal CT Scan as Follow‐up after Complete Remission with Successful Helicobacter pylori Eradication in Patients with H. pylori ‐Positive Stage I E1 Gastric MALT Lymphoma
Author(s) -
Choi Ji Young,
Lee Gin Hyug,
Ahn Ji Yong,
Kim MiYoung,
Lee Jeong Hoon,
Choi KwiSook,
Kim Do Hoon,
Choi Kee Don,
Song Ho June,
Jung HwoonYong,
Kim JinHo
Publication year - 2011
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/j.1523-5378.2010.00807.x
Subject(s) - helicobacter pylori , medicine , gastroenterology , malt lymphoma , lymphoma , gastric lymphoma , stage (stratigraphy) , mucosa associated lymphoid tissue , endoscopy , stomach , paleontology , biology
Background: Eradication of Helicobacter pylori with antibiotics is the established initial treatment of patients with localized gastric mucosa‐associated lymphoid tissue (MALT) lymphoma. However, there are few reports on follow‐up modalities to identify sustained remission in patients who achieve complete remission (CR). We therefore investigated the role of abdominal computed tomography (CT) as follow‐up after CR with H. pylori eradication. Patients and Methods: We retrospectively analyzed 122 patients with H. pylori ‐positive stage I E1 gastric MALT lymphoma who achieved CR with successful H. pylori eradication. Results: The median follow‐up after CR was 35 months (range 3–140months). At a median of 17 months (range 12–21 months) after CR, 7 of 122 patients (5.7%) experienced lymphoma recurrence, all cases of which were confined to the gastric mucosa and were detectable only by endoscopy with multiple biopsies. At the time of recurrence, four of seven patients showed re‐infection by H. pylori . Eradication therapy was successful in these patients, resulting in both bacterial eradication and tumor regression. Three patients who experienced histologic recurrence without H. pylori re‐infection were observed by a watch and wait strategy and again achieved CR. Conclusions: None of the patients with H. pylori ‐positive stage I E1 gastric MALT lymphoma who experienced tumor recurrence after CR with successful H. pylori eradication showed recurrence at extragastric sites, including lymph nodes without gastric mucosal lesion. These findings indicate that endoscopic biopsies without abdominal CT scans are sufficient to detect recurrence in these patients.