Clinical and prognostic analysis of extranodal marginal zone B cell lymphoma of mucosa-associated lymphoid tissue occurring in oromaxillofacial head and neck region

doi:10.19438/j.cjoms.2019.05.007

Abstract

Abstract: PURPOSE: This retrospective study was performed to explore the clinical profile,staging,treatment and prognosis of extranodal marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) occurring in oromaxillofacial head and neck region, in order to provide more medical evidence for the clinical practice. METHODS: One hundred and five patients with MALT lymphoma occurring in oromaxillofacial head and neck region from the Department of Oromaxillofacial Head and Neck Oncology of Shanghai Ninth People's Hospital were included in this retrospective analysis. SPSS 22.0 software package was used for data analysis. RESULTS: The female-to-male ratio was 2.5∶1. Median age at diagnosis was 56 years (range, 18-86 years). The most common clinical manifestation was progressive swelling of local sites; 52% of patients had long-term xerostomia, confirmed autoimmune diseases or chronic parotitis. According to Ann Arbor staging, 48 patients were in stage Ⅰ, 25 in stage Ⅱ, 7 in stage Ⅲ, 25 in stage Ⅳ. Only one patient had B symptom and no patients had bone marrow involvement. The most common sites were parotid gland, palate and submandibular gland. Fifty patients received single treatment and 49 patients received combined modality treatment.The median follow-up time was 60 months and 8 patients were lost to follow-up. The complete response rate after initial treatment was 80%. Tumor progression was observed in 12 patients and 14 patients died. The 5-year overall survival(OS) and progression-free survival(PFS) were 89% and 88%, respectively. Systemic treatment(chemotherapy or rituximab) was able to significantly improve PFS in patients with disseminated disease(P<0.05). MALT-IPI was an independent prognostic factor affecting OS and Ann Arbor staging affecting PFS. CONCLUSIONS: The outcome of initial treatment is satisfactory and the disease progresses slowly. Systemic therapy may improve PFS in patients with disseminated disease. MALT-IPI and Ann Arbor staging are independent prognostic factors.

Key words: MALT lymphoma, Oromaxillofacial head and neck region, MALT-IPI, Ann Arbor staging

CLC Number:

R739.8

ZHANG Tian, WU Yun-teng, GUO Wei. Clinical and prognostic analysis of extranodal marginal zone B cell lymphoma of mucosa-associated lymphoid tissue occurring in oromaxillofacial head and neck region[J]. China Journal of Oral and Maxillofacial Surgery, 2019, 17(5): 424-430.

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