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Ibrahim A. Al-mofleh - One of the best experts on this subject based on the ideXlab platform.

  • Primary Gastric Lymphoma.
    World journal of gastroenterology, 2004
    Co-Authors: Ahmad M Al-akwaa, Neelam Siddiqui, Ibrahim A. Al-mofleh
    Abstract:

    AIM: The purpose of this review is to describe the various aspects of primary Gastric Lymphoma and the treatment options currently available. METHODS: After a systematic search of Pubmed, Medscape and MDconsult, we reviewed and retrieved literature regarding Gastric Lymphoma. RESULTS: Primary Gastric Lymphoma is rare however, the incidence of this malignancy is increasing. Chronic gastritis secondary to Helicobacter pylori (H pylori) infection has been considered a major predisposing factor for MALT Lymphoma. Immune histochemical marker studies and molecular biology utilizing polymerase chain reaction have facilitated appropriate diagnosis and abolished the need for diagnostic surgical resection. Advances in imaging techniques including Magnetic Resonance Imaging (MRI) and Endoscopic Ultrasonography (EUS) have helped evaluation of tumor extension and invasion. The clinical course and prognosis of this disease is dependent on histopathological sub-type and stage at the time of diagnosis. Controversy remains regarding the best treatment for early stages of this disease. Chemotherapy, surgery and combination have been studied and shared almost comparable results with survival rate of 70%-90%. However, chemotherapy possesses the advantage of preserving Gastric anatomy. Radiotherapy alone has been tried and showed good results. Stage IIIE, IVE disease treatment is solely by chemotherapy and surgical resection has been a remote consideration. CONCLUSION: We conclude that methods of diagnosis and staging of the primary Gastric Lymphoma have dramatically improved. The modalities of treatment are many and probably chemotherapy is superior because of high success rate, preservation of stomach and tolerable complications.

  • Primary Gastric Lymphoma.
    Cancer Control, 2001
    Co-Authors: Ahmad M Al-akwaa, Neelam Siddiqui, Ibrahim A. Al-mofleh
    Abstract:

    The records of 50 patients with localized primary Gastric Lymphoma were reviewed and clinical and prognostic factors characterized. Pathologic material was reclassified according to Rappaport's, Lukes-Collins, and Lennert's Kiel classifications. Factors with the greatest prognostic significance included initial stage as determined by surgery and pathology, absolute tumor size, degree of penetration through the stomach wall, and histologic grade of the Lymphoma.

Ahmad M Al-akwaa - One of the best experts on this subject based on the ideXlab platform.

  • Primary Gastric Lymphoma.
    World journal of gastroenterology, 2004
    Co-Authors: Ahmad M Al-akwaa, Neelam Siddiqui, Ibrahim A. Al-mofleh
    Abstract:

    AIM: The purpose of this review is to describe the various aspects of primary Gastric Lymphoma and the treatment options currently available. METHODS: After a systematic search of Pubmed, Medscape and MDconsult, we reviewed and retrieved literature regarding Gastric Lymphoma. RESULTS: Primary Gastric Lymphoma is rare however, the incidence of this malignancy is increasing. Chronic gastritis secondary to Helicobacter pylori (H pylori) infection has been considered a major predisposing factor for MALT Lymphoma. Immune histochemical marker studies and molecular biology utilizing polymerase chain reaction have facilitated appropriate diagnosis and abolished the need for diagnostic surgical resection. Advances in imaging techniques including Magnetic Resonance Imaging (MRI) and Endoscopic Ultrasonography (EUS) have helped evaluation of tumor extension and invasion. The clinical course and prognosis of this disease is dependent on histopathological sub-type and stage at the time of diagnosis. Controversy remains regarding the best treatment for early stages of this disease. Chemotherapy, surgery and combination have been studied and shared almost comparable results with survival rate of 70%-90%. However, chemotherapy possesses the advantage of preserving Gastric anatomy. Radiotherapy alone has been tried and showed good results. Stage IIIE, IVE disease treatment is solely by chemotherapy and surgical resection has been a remote consideration. CONCLUSION: We conclude that methods of diagnosis and staging of the primary Gastric Lymphoma have dramatically improved. The modalities of treatment are many and probably chemotherapy is superior because of high success rate, preservation of stomach and tolerable complications.

  • Primary Gastric Lymphoma.
    Cancer Control, 2001
    Co-Authors: Ahmad M Al-akwaa, Neelam Siddiqui, Ibrahim A. Al-mofleh
    Abstract:

    The records of 50 patients with localized primary Gastric Lymphoma were reviewed and clinical and prognostic factors characterized. Pathologic material was reclassified according to Rappaport's, Lukes-Collins, and Lennert's Kiel classifications. Factors with the greatest prognostic significance included initial stage as determined by surgery and pathology, absolute tumor size, degree of penetration through the stomach wall, and histologic grade of the Lymphoma.

Martin S. Karpeh - One of the best experts on this subject based on the ideXlab platform.

  • The Diminishing Role of Surgery in the Treatment of Gastric Lymphoma
    Annals of surgery, 2004
    Co-Authors: Sam S. Yoon, Daniel G. Coit, Carol S. Portlock, Martin S. Karpeh
    Abstract:

    Over the past decade, the management of patients with Gastric Lymphoma has undergone significant changes with a shift toward nonsurgical treatment. Factors influencing this shift include a better understanding of the etiology of this disease and recent clinical studies demonstrating the efficacy of Helicobacter pylori (H. pylori) eradication therapy, radiation therapy, and chemotherapy. Numerous studies have shown that localized low-grade, mucosa-associated lymphoid tissue (MALT) Gastric Lymphomas can regress after H. pylori eradication therapy.1 If such therapy fails, relatively low doses (30 Gy) of external beam radiation can control Gastric MALT Lymphoma in up to 100% of cases.2 Combinations of chemotherapy and radiation therapy can effectively treat low- and high-grade Gastric Lymphomas.3 This article will present an overview of the diagnosis and workup of patients with Gastric Lymphoma, review the current literature on treatment options, and provide an algorithm for treatment. Lymphomas of the stomach are of the non-Hodgkin type. In 2003, there were an estimated 53,400 new cases of non-Hodgkin Lymphoma (NHL) and 28,300 deaths in the United States.4 Over the past 4 decades, there has been a steady increase in the incidence of NHL of approximately 3% per year. Deaths from NHL have also steadily increased, but more slowly than the incidence. NHL usually originates in lymph node basins but can also occur in extranodal sites. The gastrointestinal tract is the most common site of extranodal NHL and accounts for 10 to 15% of all NHL cases.5 Gastrointestinal NHL occurs in the stomach in nearly half of cases.6 Based on these figures, one could estimate that about 3000 new cases of primary Gastric Lymphoma are diagnosed each year in the United States. There are a number of risk factors for gastrointestinal NHL, including infection with human immunodeficiency virus (HIV), immunosuppression after solid organ transplantation, celiac disease, and inflammatory bowel disease.7 The primary risk factor for Gastric Lymphoma is infection with H. pylori.8 Some authors have reported a small but significant increased risk of other malignancies in patients with Gastric Lymphoma, particularly adenocarcinoma of the stomach.9,10 The median age of diagnosis for Gastric Lymphoma is approximately 60 years old, and the disease affects an equal number of men and women.11 The most common presenting symptom is abdominal pain and loss of appetite.3 Other symptoms include weight loss, gastrointestinal bleeding, and vomiting. B symptoms (weight loss, fever, night sweats) are present in about 12% of patients. Given that these symptoms are nonspecific, there is often a delay in diagnosis. In 1 study, 96% of patients were symptomatic, and the median time from the onset of symptoms to diagnosis was about 3 months.3

  • Long-term follow-up after curative surgery for early Gastric Lymphoma.
    Annals of surgery, 1996
    Co-Authors: David L. Bartlett, Martin S. Karpeh, Daniel A. Filippa, Murray F. Brennan
    Abstract:

    Objective This study was designed to examine the long-term survival of a homogenous group of patients with stage IE or IIE-1 Gastric Lymphoma after complete surgical resection. Summary Background Data The management of Gastric Lymphoma remains controversial. Enthusiasm for multimodality approaches for Gastric Lymphoma has lead to the current trend of using chemotherapy as primary treatment, thus avoiding Gastric resection. Surgery, however, may result in improved long-term survival rates. Methods The records of all patients with the diagnosis of Gastric Lymphoma from 1980 to 1991 were reviewed retrospectively. Of 106 patients examined, 34 underwent curative resection and regional lymphadenectomy for pathologically staged IE or IIE-1 (pN1) Gastric Lymphoma. Fifteen patients underwent surgery alone, whereas 19 also received postoperative adjuvant therapy. Results The median follow-up time was 74 months. The 10-year actuarial disease-free survival was 91% for stage IE disease (n = 23) and 82% for stage IIE-1 disease (n = 11). There were no operative deaths and a 26% morbidity rate. No difference in survival was found for those treated with adjuvant therapy. Conclusions The results compare favorably to those reported with the use of primary chemotherapy and radiation therapy and suggest that surgery remains the best frontline therapy for early Gastric Lymphoma.

Hajime Nawata - One of the best experts on this subject based on the ideXlab platform.

  • Endoscopic ultrasonography in staging a primary early Gastric Lymphoma: report of a case.
    Fukuoka igaku zasshi = Hukuoka acta medica, 1991
    Co-Authors: Y Pae, Tadashi Misawa, Kazuya Akahoshi, H Fujishima, Yoshiharu Chijiiwa, Masao Tanaka, Hajime Nawata
    Abstract:

    A 74-year-old woman with a history of a benign Gastric polyp was admitted to our hospital with a complaint of epiGastric discomfort. A diagnosis of primary Gastric Lymphoma was confirmed by endoscopy and results of abrasive cytology. Endoscopic ultrasonography (EUS), performed prior to surgery, demonstrated clearly the submucosal invasion of the Gastric Lymphoma. Histopathology on the depth and the involvement of periGastric lymph nodes of surgical specimen confirmed the accuracy of the EUS findings. Thus EUS offers a means of early preoperative diagnosis and staging of Gastric Lymphoma, and that is superior to conventional endoscopy in such cases.

  • Staging and follow-up of primary Gastric Lymphoma by endoscopic ultrasonography.
    The American journal of gastroenterology, 1991
    Co-Authors: H Fujishima, Tadashi Misawa, Yoshiharu Chijiiwa, A. Maruoka, Sakai K, Hajime Nawata
    Abstract:

    The usefulness of endoscopic ultrasonography (EUS) was assessed for diagnosing the depth of invasion in the Gastric wall, the infiltration to the adjacent organs, and detecting regional lymph node involvement in primary Gastric Lymphoma. EUS was performed in 11 patients with primary Gastric Lymphoma who subsequently underwent gastrectomy with lymph node dissection, as well as chemotherapy in some cases. EUS findings showed a good correlation with the histopathology of the resected specimens. An accurate diagnosis of the depth of invasion into the Gastric wall was made in 10 of 11 patients using the same T grade of the 1987 TNM system for Gastric carcinoma. EUS also clearly visualized the reduction of depth of tumor invasion in two patients who underwent chemotherapy. PeriGastric lymph node involvement could be detected accurately in nine of 11 patients. In conclusion, EUS is an excellent and sensitive diagnostic modality for the preoperative staging and follow-up of primary Gastric Lymphoma.

Neelam Siddiqui - One of the best experts on this subject based on the ideXlab platform.

  • Primary Gastric Lymphoma.
    World journal of gastroenterology, 2004
    Co-Authors: Ahmad M Al-akwaa, Neelam Siddiqui, Ibrahim A. Al-mofleh
    Abstract:

    AIM: The purpose of this review is to describe the various aspects of primary Gastric Lymphoma and the treatment options currently available. METHODS: After a systematic search of Pubmed, Medscape and MDconsult, we reviewed and retrieved literature regarding Gastric Lymphoma. RESULTS: Primary Gastric Lymphoma is rare however, the incidence of this malignancy is increasing. Chronic gastritis secondary to Helicobacter pylori (H pylori) infection has been considered a major predisposing factor for MALT Lymphoma. Immune histochemical marker studies and molecular biology utilizing polymerase chain reaction have facilitated appropriate diagnosis and abolished the need for diagnostic surgical resection. Advances in imaging techniques including Magnetic Resonance Imaging (MRI) and Endoscopic Ultrasonography (EUS) have helped evaluation of tumor extension and invasion. The clinical course and prognosis of this disease is dependent on histopathological sub-type and stage at the time of diagnosis. Controversy remains regarding the best treatment for early stages of this disease. Chemotherapy, surgery and combination have been studied and shared almost comparable results with survival rate of 70%-90%. However, chemotherapy possesses the advantage of preserving Gastric anatomy. Radiotherapy alone has been tried and showed good results. Stage IIIE, IVE disease treatment is solely by chemotherapy and surgical resection has been a remote consideration. CONCLUSION: We conclude that methods of diagnosis and staging of the primary Gastric Lymphoma have dramatically improved. The modalities of treatment are many and probably chemotherapy is superior because of high success rate, preservation of stomach and tolerable complications.

  • Primary Gastric Lymphoma.
    Cancer Control, 2001
    Co-Authors: Ahmad M Al-akwaa, Neelam Siddiqui, Ibrahim A. Al-mofleh
    Abstract:

    The records of 50 patients with localized primary Gastric Lymphoma were reviewed and clinical and prognostic factors characterized. Pathologic material was reclassified according to Rappaport's, Lukes-Collins, and Lennert's Kiel classifications. Factors with the greatest prognostic significance included initial stage as determined by surgery and pathology, absolute tumor size, degree of penetration through the stomach wall, and histologic grade of the Lymphoma.