Mucosa-Associated Lymphoid Tissue Follow-up

  • Author: Sara J Grethlein, MD; Chief Editor: Emmanuel C Besa, MD   more...
 
Updated: Dec 6, 2011
 

Further Outpatient Care

  • Patients with MALToma should continue to receive serial examinations at increasing frequencies for several years following the successful completion of therapy.
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Prognosis

  • Generally, low-grade MALTomas are indolent neoplasms with a fairly good prognosis.
  • MALTomas that are not eradicated by treatment of H. pylori infection are incurable but are associated with a long course.
  • Although the intermediate-grade, diffuse, large B-cell MALTomas are more aggressive malignancies, the cure rate may be as high as 90% for stage IE disease and is approximately 30-40% for extensive stage IIIE or IVE disease. These outcomes are similar to non-MALT intermediate-grade NHLs.
  • Gastric MALTomas have a stage-dependent prognosis. The survival rate for stage IE disease is 93% at 5 years and 58% at 10 years.[21] Long-term responses to anti– H. pylori treatment alone have been reported.
  • Nongastrointestinal MALTomas are most common in the head and neck, ocular adnexa, and lungs.
  • Several small studies have reported that observation alone may be appropriate in selected patients with ocular adnexal MALToma.
    • The prognosis depends on the grade of the tumor, with long-term survival possible for patients with low-grade tumors. However, achieving a cure is more difficult in patients with MALTomas in advanced stages.
    • Use of the International Prognostic Index — taking into account age, Ann Arbor stage, lactate dehydrogenase (LDH) levels, the number of extranodal sites, and performance status — has better characterized low-, intermediate-, and high-risk groups. Five-year survival rates in these groups are 99% for the low-risk groups; 85-88%, intermediate-risk groups; and 72%, for high-risk groups. Patients with early-stage MALToma may be curable with chemotherapy.
    • The risks and benefits of surgical or radiation therapy for MALTomas should be considered before proceeding.
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Contributor Information and Disclosures
Author

Sara J Grethlein, MD  Senior Attending Physician, Cancer Treatment Center, Bassett Healthcare Network

Sara J Grethlein, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Society of Clinical Oncology, and American Society of Hematology

Disclosure: Nothing to disclose.

Coauthor(s)

Jose A Perez Jr, MD, MBA, MSEd  Consulting Staff, Department of Medicine, Methodist Hospital; Associate Professor of Clinical Medicine, Weill Cornell Medical College

Jose A Perez Jr, MD, MBA, MSEd is a member of the following medical societies: American College of Physician Executives, American College of Physicians, Society of General Internal Medicine, and Society of Hospital Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Karen Seiter, MD  Professor, Department of Internal Medicine, Division of Oncology/Hematology, New York Medical College

Karen Seiter, MD is a member of the following medical societies: American Association for Cancer Research, American College of Physicians, and American Society of Hematology

Disclosure: Novartis Honoraria Speaking and teaching; Novartis Consulting fee Speaking and teaching; Eisai Honoraria Speaking and teaching; Celgene Honoraria Speaking and teaching

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Troy H Guthrie, Jr, MD  Director of Cancer Institute, Baptist Medical Center

Troy H Guthrie, Jr, MD is a member of the following medical societies: American Federation for Medical Research, American Medical Association, American Society of Hematology, Florida Medical Association, Medical Association of Georgia, and Southern Medical Association

Disclosure: Nothing to disclose.

Rajalaxmi McKenna, MD, FACP  Southwest Medical Consultants, SC, Department of Medicine, Good Samaritan Hospital, Advocate Health Systems

Rajalaxmi McKenna, MD, FACP is a member of the following medical societies: American Society of Clinical Oncology, American Society of Hematology, and International Society on Thrombosis and Haemostasis

Disclosure: Nothing to disclose.

Chief Editor

Emmanuel C Besa, MD  Professor, Department of Medicine, Division of Hematologic Malignancies, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson University

Emmanuel C Besa, MD is a member of the following medical societies: American Association for Cancer Education, American College of Clinical Pharmacology, American Federation for Medical Research, American Society of Clinical Oncology, American Society of Hematology, and New York Academy of Sciences

Disclosure: Nothing to disclose.

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