Abstract
Primary gastric lymphoma (PGL) is not a common cancer and account for 10% of malignant lymphoma and 5% of gastric cancer. The correlation with Helicobacter pylori (H. pylori) infection with mucosa associated lymphoepithelial tumor (MALT) is now well documented and some of the low grade MALT can be cured sorely by triple agent eradication therapy. The most common type of PGL is diffuse large B cell lymphoma which now can be successfully treated with chemotherapy alone. There is still no consensus on the optimal treatment for PGL. In the recent 10 years chemotherapy combined with anti-CD 20 monoclonal antibody such as rituximab, achieved higher complete response rate and more than 80% are long-term survival. The so-called R-CHOP (rituximab, cyclophosphamide, vincristin, prednisolone) now become the new gold standard therapy. The role of surgical resection prior to chemotherapy is controversial and not commonly applied in recent publications. Yet some cases of suboptimal response to R-CHOP or patient is too fragile to tolerate the immuno-chemotherapy will be feasible to surgical resection as a salvage or alternative therapy. The radiotherapy as an adjuvant therapy is less commonly considered. Patients with advanced PGL with high international prognostic index risk and along with co-morbidity diseases are prone to get treatment related complications from above-mentioned modality of treatment, such as GI perforation, neutropenic septicemia, pulmonary infection, fulminate heaptitis B reactivation, respiratory and cardiac impairment can be seen.
Highlights
With great improvement of modern chemotherapy and supportive care, a global therapeutic approach to the cure of Primary gastric lymphoma (PGL) has completely changed over the last one decade: innovative, conservative options to reduce treatment toxicity, preventing systemic relapses, have made their appearance and are on the rise
In the recent 10 years chemotherapy combined with anti-CD20 monoclonal antibody such as rituximab, achieved higher complete response rate and more than 80% are long-term survival
The treatment paradigm of PGL is shifting from surgery to combined surgery and chemotherapy or radiotherapy, to chemotherapy alone and rituximab containing chemotherapy is considered as the mainstay
Summary
With great improvement of modern chemotherapy and supportive care, a global therapeutic approach to the cure of PGL has completely changed over the last one decade: innovative, conservative options to reduce treatment toxicity, preventing systemic relapses, have made their appearance and are on the rise. The role of surgical resection prior to chemotherapy is controversial and not commonly applied in recent publications [1,2,3,4]. The primary role of surgery or chemotherapy remains the mainstay is an issue of debate [4]. There is, as yet, no randomized control trial to define the primary treatment of PGL, either surgery or. This article tries to answer this controversy and delineate the current treatment of MALT lymphoma. The pathogenesis and genetic aberration of large cell transformation from high grade MALT will be discussed
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
