Editing Gastric lymphoma (section)

== '''Treatment''' ==

* Chemotherapy
** Most commonly R-CHOP
** Associated with a 5% rate of      gastric perforation and GI bleeding
* Indications for surgery
** Symptomatic recurrence after      treatment failure
** Complications (bleeding,      gastric outlet obstruction, perforation)
* MALT
** Must evaluate for H. pylori      infection
** Early-stage MALT and active      H. pylori infection may be treated by eradication alone - successful      eradication results in remission for 75%, but need repeat endoscopy in 2      months and 6 monthly endoscopy for 3 years to document regression
** Predictors of failure from      eradication alone:
*** Trans-mural tumour       extension
*** Nodal involvement
*** Transformation into a large       cell phenotype
*** Nuclear BCL-10 expression
** MALT and H. pylori negative:
*** Consider radiotherapy if       all involved sites can be encompassed in a single field
*** Otherwise chemotherapy
** Risk factors for poor      prognosis:
*** Age >=70
*** Stage IV disease
*** Elevated LDH
*** 5 year survival of 98.7%       for no risk factors, 93.1% for one risk factor and 64.3% for two or       three risk factors

[[Category:UGIS]]