Advances in the Management of Gastric Lymphomas: Integrating Global Evidence Into Clinical Practice

Introduction and purpose: This narrative review explores gastric lymphomas, focusing on their epidemiology, diagnosis, treatment, and prognosis. It aims to integrate international guidelines with Polish clinical practice to address the diagnostic and therapeutic challenges associated with these rare and histologically diverse malignancies. Results: Primary gastric lymphomas, particularly MALT lymphoma and DLBCL, require individualized management. MALT lymphoma is highly responsive to Helicobacter pylori eradication, with success rates reaching up to 80% in localized cases. However, the presence of the t(11;18)(q21;q21) translocation indicates a reduced response and necessitates additional treatment, such as radiotherapy or immunochemotherapy. For gastric DLBCL, R-CHOP remains the standard of care, and surgery has been largely replaced by organ-preserving strategies. Polish clinical protocols align with international standards, emphasizing bismuth-based eradication regimens and the growing role of molecular diagnostics. Conclusion: Effective management of gastric lymphomas requires a multidisciplinary and individualized approach that accounts for histologic subtype, stage, H. pylori status, and molecular features. Non-surgical, evidence-based strategies significantly improve outcomes, with Polish practice reflecting global standards in antibiotic stewardship and precision oncology.