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4 standard-of-care settings across 3 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Diagnosis and staging | Endoscopy with multiple biopsies from the abnormal area and from every region of the stomach, because the lymphoma is patchy and a single biopsy can miss it. Helicobacter pylori is sought by more than one method. Endoscopic ultrasound measures how deep the lymphoma goes, which predicts whether antibiotics alone will work; in a prospective comparison against the resected stomach it judged the depth correctly in 91.5 per cent of cases. Fluorescence in situ hybridisation for t(11;18) is done where it will change the plan. Staging uses the gastrointestinal system that counts depth and node involvement rather than the ordinary node-region count. | WHO Classification of Haematolymphoid Tumours, 5th edition (2022), with the International Consensus Classification (2022) where they differ | 95 |
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | First treatment: eradicate the bacterium | A standard eradication regimen of a proton pump inhibitor with two antibiotics, chosen by local resistance patterns, is the first treatment for Helicobacter pylori-positive disease and is also offered in negative disease, where a minority still respond. Success is confirmed by a breath or stool test after treatment, and the lymphoma is then followed by repeated endoscopy and biopsy over months, because regression is slow. In the prospective series of 120 patients with stage I disease, 80 per cent achieved complete histological remission and 80 per cent of those remained in continuous remission at a median follow-up of 75 months. | Fischbach, J Clin Oncol 2005; ESMO marginal zone lymphoma guideline; NCI PDQ | - |
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Residual disease on a follow-up biopsy | Residual lymphoma on a biopsy after successful eradication is common and usually does not need treatment. In the same series, 17 per cent of those who had reached complete remission later showed histological residual disease; they were watched rather than treated, and all of them entered a second remission. A persisting monoclonal band in the immunoglobulin genes is also common and is not by itself a reason to treat. What does need action is growth, new symptoms, or large cells appearing on the biopsy. | Fischbach, J Clin Oncol 2005 | 95 | |
| All comers | When antibiotics do not work, or cannot | Radiotherapy to the stomach at a low dose is the usual next step for disease that stays localised, and anti-CD20 antibody treatment, alone or with chemotherapy, for disease that has spread or that carries t(11;18) and is therefore unlikely to respond to eradication. Surgery has essentially no role at any stage, which is the main difference from gastric cancer. The regimens, the doses and the evidence are on the MALT lymphoma page and in the treatment layer of this family. | NCI PDQ: adult non-Hodgkin lymphoma treatment | 84 |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.