The median age at death was 86 years (IQR 76 to 88 years) The ov

The median age at death was 86 years (IQR 76 to 88 years). The overall survival rate was 75% (95% CI: 58% to 93%) at 5 years and 62.5% (95% CI: 40% to 85%) at 10 years after diagnosis (Figure 2). Figure 2 Overall survival curve of all www.selleckchem.com/products/brefeldin-a.html patients with gastric EMZBL-MALT Discussion Two third of subjects (67%) had Helicobacter infection in this series. This figure was quite similar to that in a local study (12), which reported 62%

of subjects were HP-positive using histopathologic examination. However, little higher proportion of HP-positive Inhibitors,research,lifescience,medical subject was found in other Asian and Western series, ranging from 76% to 91% (4,10,13). This discrepancy could be partially explained by the reason that two or more methods were applied to detect HP in these series while in the present study, only histopathologic examination was used. The accuracy of histopathologic examination was affected by inter-observer variation and sampling error, especially in patients taking anti-secretory agents or antibiotics. In this study, Helicobacter infection was only found after subsequent Inhibitors,research,lifescience,medical but not initial OGD in 3 subjects, revealing that it was not uncommon to miss this Inhibitors,research,lifescience,medical microbe. Since Helicobacter status affects treatment option

of gastric EMZBL-MALT significantly, it is advisable to consider additional non-invasive means of HP detection, like urea breath test or serology test, if HP is not identified in gastric biopsy. We found that remission of gastric EMZBL-MALT was achieved after Helicobacter eradication in 85% of Helicobacter-positive subjects. This figure Inhibitors,research,lifescience,medical was comparable to the result of several reported large series from Western and Asian regions, ranging from 89-94% (1-5). Delayed histological regression of lymphoma after successful Helicobacter eradication is not uncommonly encountered in clinical practice. In this series, one subject, with early resolution of endoscopic abnormality, only achieved histological regression around 15 months Inhibitors,research,lifescience,medical after antibacterial treatment. Such delay was also described in different studies and could be more than

30 months (13). Hence, a wait-and-watch approach seems reasonable if there is persistent histological evidence of lymphoma in patients whose clinical and endoscopic manifestations improve after successful AV-951 HP eradication. However there is no consensus on the period of observation before declaration of treatment failure. In this series, histological regression was found within 6 months in the majority of responders (15/17 or 88%). Wundish reported that histological regression rates at 3 months and 1 year were 61% and 88% respectively (1) while Hong found response rates of 78% and 93% at 6 months and 1 year respectively (2). In view of these findings, some authors suggested physicians to observe for at least one year after successful HP eradication before making conclusion of treatment failure (2,10,13).

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