2430 - Clinical features, treatment and outcomes of colon and rectum mucosa-associated lymphoid tissue (MALT) lymphoma: Literature reviews published in English between 1993 and 2017

Background

Colorectal mucosa associated lymphoid tissue (MALT) lymphoma (CML) is rare and comprises only 2.5% of the MALT lymphomas. Its etiology and treatment are not well established. The aim of this systematic literature review is trying to characterize CML and analyzing treatment failure cases treated with various therapeutic strategies.

Methods

We reviewed cases reports on colorectal lymphoma from 1993 to 2017. A PubMed search of the English medical literature was conducted using the search words "colon," "rectum," and "Maltoma" or “MALT lymphoma” as filters. Through the review, 65 case reports were found, of which 15 case reports were excluded, due to literature written in languages other than English, poorly documented cases and combined colonic disease such as adenocarcinoma or inflammatory bowel disease. After all, 67 patients reported in 50 studies were included from PubMed search. And we added 6 patients treated for CML in our multicenter institutes. Risk factor analysis was done for treatment failure, defined as remission failure and recurrence.

Results

Of 73 patients diagnosed as CML, tumors were located in rectum in 54 patients (74.0%), 10 patients (13.6%) in right colon, 3 patients (4.1%) in the transverse colon and 6 patients (8.2%) in the sigmoid colon. The patients were achieved complete response (CR) with surgery (18/19cases), local resection (18/19 cases), chemotherapy (12/13 cases), radiation therapy (4/5cases), or antibiotics therapy including Helicobacter pylori (H. pylori) eradication (12/15 cases) in the first-line treatment. Eight cases (10.9%) needed second-line treatment for remission failure, CR was achieved in 5. The tumor recurrence occurred in 5 patients in remission patients (6.8%). The multivariable analysis showed that male, multiple tumor, first-line treatment failure was significantly related with treatment failure (p = 0.03, p = 0.05, p = 0.03, respectively).

Conclusions

Complete regression of primary CML was achieved using various therapeutic strategies. The first-line treatment failure, multiple tumors were associated with treatment failure, although the numbers of failure cases are too small to draw definitive conclusions.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The author.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.