Low sensitivity of computed tomography in the staging of gastric lymphomas of mucosa-associated lymphoid tissue: Impact on prospective trials and ordinary clinical practice

Andrès J M Ferreri, Maurilio Ponzoni, Stefano Cordio, Angelo Vanzulli, Elda Garuti, Edi Viale, Eugenio Villa

Research output: Contribution to journalArticlepeer-review

Abstract

The natural history and management of gastric lymphomas of mucosa- associated lymphoid tissue (MALTomas) are not completely understood. Most stage I cases are now entered into prospective trials to confirm the excellent results obtained with conservative treatment, whereas current therapeutic policies are based on accumulated experience. The limits of staging work-ups may have a significant impact on prospective trials and ordinary clinical practice. The authors explore the sensitivity of computed tomography scanning in detecting perigastric adenopathy in 20 patients with gastric MALToma treated by gastrectomy. Clinical staging identified 17 patients as having stage I MALTomas and three patients as having stage II1 MALTomas. Histopathologic staging showed that 8 of 17 patients formerly diagnosed with stage I MALToma had perigastric nodal involvement, whereas the three patients with clinical stage II1 were confirmed as such. Computed tomography scanning has low sensitivity in detecting perigastric lymphadenopathy in gastric MALTomas. This leads to understaging, with a significant impact on therapeutic decision, and distorts newly acquired knowledge about the disease's natural history and management, introducing a bias in prospective clinical trials. Endoscopic ultrasonography should be tested as a staging procedure both in prospective trials and in ordinary clinical practice.

Original languageEnglish
Pages (from-to)614-616
Number of pages3
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume21
Issue number6
DOIs
Publication statusPublished - Dec 1998

Keywords

  • Computed tomography
  • Eradication therapy
  • Gastric lymphomas
  • Lymphoma of mucosa-associated lymphoid tissue
  • Mucosa-associated lymphoid tissue
  • Non-Hodgkin lymphomas
  • Staging

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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