Clinical features and prognostic factors in solitary plasmacytoma

Finsinger, Paola; Grammatico, Sara; Chisini, Marta; Piciocchi, Alfonso; Foà, Roberto; Petrucci, Maria Teresa

doi:10.1111/bjh.13870

Cited by 71 publications

(86 citation statements)

References 41 publications

(75 reference statements)

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“…This was not in accordance with results reported by Jawad et al and Knobel et al [5, 10]. However, a recent retrospective study by Finsinger et al, who evaluated 53 patients, found there was a significant difference in progression-free survival (PFS) between patients who received RT and those who received other treatment modalities [24]. Despite the excellent local control, in our study, at least 70% of patients who received RT progressed to myeloma.…”

Section: Discussionmentioning

confidence: 74%

Solitary plasmacytoma: population-based analysis of survival trends and effect of various treatment modalities in the USA

et al. 2017

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BackgroundSolitary plasmacytoma (SP) is a localized neoplastic plasma cell disorder with an annual incidence of less than 450 cases. Given the rarity of this disorder, it is difficult to conduct large-scale population studies. Consequently, very limited information on the disorder is available, making it difficult to estimate the incidence and survival rates. Furthermore, limited information is available on the efficacy of various treatment modalities in relation to primary tumor sites.MethodsThe data for this retrospective study were drawn from the Surveillance, Epidemiology and End Results (SEER) database, which comprises 18 registries; patient demographics, treatment modalities and survival rates were obtained for those diagnosed with SP from 1998 to 2007. Various prognostic factors were analyzed via Kaplan-Meier analysis and log-rank test, with 5-year relative survival rate defined as the primary outcome of interest. Cox regression analysis was employed in the multivariate analysis.ResultsThe SEER search from 1998 to 2007 yielded records for 1691 SP patients. The median age at diagnosis was 63 years. The patient cohort was 62.4% male, 37.6% female, 80% Caucasian, 14.6% African American and 5.4% other races. Additionally, 57.8% had osseous plasmacytoma, and 31.9% had extraosseous involvement. Unspecified plasmacytoma was noted in 10.2% of patients. The most common treatment modalities were radiotherapy (RT) (48.8%), followed by combination surgery with RT (21.2%) and surgery alone (11.6%). Univariate analysis of prognostic factors revealed that the survival outcomes were better for younger male patients who received RT with surgery (p < 0.05). Additionally, patients who received neoadjuvant RT had increased survival rates compared to those receiving adjuvant RT (86% vs 73%, p < 0.05). Furthermore, the analyses revealed that 5-year survival rates for patients with axial plasmacytoma were superior when RT was combined with surgery (p < 0.05). In the multivariate analysis, age <60 years and treatment with either RT or surgery showed superior survival rates. Progression to multiple myeloma (MM) was noted in 551 patients. Age >60 years was associated with a lower 5-year survival in patients who progressed to MM compared to those who were diagnosed initially with MM (15.1 vs 16.6%). Finally, those who received RT and progressed to MM still had a higher chance of survival than those who were diagnosed with MM initially and treated with RT/surgery (21.8% vs 15.9%, p < 0.05).ConclusionsA review of the pertinent literature indicates that we provided the most comprehensive population-based analysis of SP to date. Moreover, our study contributes to the establishment of the optimal SP treatment modality, as RT is the favored option in frontline settings. Consensus is currently lacking regarding the benefits of combined treatment including surgery. Thus, the findings reported here elucidate the role of primary treatment modalities while also demonstrating the quantifiable benefits of combining RT with surgery in relation to...

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Section: Discussionmentioning

confidence: 74%

Solitary plasmacytoma: population-based analysis of survival trends and effect of various treatment modalities in the USA

et al. 2017

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“…Solitary extramedullary plasmacytoma (SEP) is a rare tumor accounting for only 3–5% of all plasma cell neoplasms [6]. It is defined as either primary, when it occurs as isolated mass, or secondary, when it is associated with generalized multiple myeloma.…”

Section: Discussionmentioning

confidence: 99%

“…Regional recurrence and distant metastasis may develop in 22% of patients and 15% will develop generalized myeloma [8]. SEP prognosis is considered good with a median survival of approximately 10 years [6]. …”

Section: Discussionmentioning

confidence: 99%

Solitary Plasmacytoma of the Mesentery: A Systematic Clinician’s Diagnosis

Mitropoulou

Zizi-Sermpetzoglou

Moschouris

et al. 2017

Case Reports in Oncological Medicine

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Introduction Plasmacytoma is an uncommon plasma cell neoplasm and its localized form is solitary plasmacytoma of the bone and solitary extramedullary plasmacytoma. Solitary plasmacytoma of the mesentery is extremely rare, reported only in a handful of cases. Case Presentation A 47-year-old man with nonspecific abdominal complains was found to have an ill-defined mass on his mesenteric root. Laparoscopic biopsy and stepwise histopathological examination revealed a mesenteric plasmacytoma, and extensive imaging and laboratory investigations led to the diagnosis of the solitary mesenteric plasmacytoma. The patient underwent definitive radiotherapy and remains under remission one year later. Discussion Plasma cell dyscrasias include a variant of proliferative disease, characterized by clonal expansion of bone marrow plasma cells, producing a massive quantity of monoclonal immunoglobulin called paraprotein or M-protein. Solitary extramedullary plasmacytoma accounts for only 3–5% of all plasma cell neoplasms. Meticulous adherence to the established diagnostic criteria helps the clinician to set the correct, yet very unusual and unexpected diagnosis.

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“…It accounts for 3 to 5% of all plasma cell neoplasms [1]. Almost 85% of EMPs involve the head and neck mucosa, especially in the upper respiratory tract [2]. Gastrointestinal, lung, bladder, and testis involvement have also been reported.…”

Section: Introductionmentioning

confidence: 99%

Primary solitary plasmacytoma of the liver – successful treatment with fractionated stereotactic radiotherapy (Cyberknife®): a case report

Chalopin

Barillot

Biny³

et al. 2017

J Med Case Reports

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BackgroundSolitary plasmacytoma of the liver is a very rare and aggressive form of plasma cell dyscrasia. To the best of our knowledge, very few cases have been reported without systemic disease. We reported a rare case of hepatic solitary plasmacytoma that successfully responded to fractionated stereotactic radiotherapy.Case presentationA 64-year-old white French man had monoclonal gammopathy of the immune globulin G lambda type; he developed a cholestasis and cytolysis with the discovery of a subscapular nodule. A biopsy showed plasma cells and, for several reasons, the decision was made to use the fractionated stereotactic radiotherapy strategy. After 20 months, he is asymptomatic and the immune globulin G component has completely disappeared.ConclusionWe suggest considering Cyberknife® radiosurgery as an option for the treatment of hepatic solitary plasmacytoma.

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Clinical features and prognostic factors in solitary plasmacytoma

Cited by 71 publications

References 41 publications

Solitary plasmacytoma: population-based analysis of survival trends and effect of various treatment modalities in the USA

Solitary plasmacytoma: population-based analysis of survival trends and effect of various treatment modalities in the USA

Solitary Plasmacytoma of the Mesentery: A Systematic Clinician’s Diagnosis

Primary solitary plasmacytoma of the liver – successful treatment with fractionated stereotactic radiotherapy (Cyberknife®): a case report

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