Solitary extramedullary plasmacytoma of the head and neck—Long‐term outcome analysis of 68 cases

Bachar, Gideon; Goldstein, David; Brown, Dale; Tsang, Richard W.; Lockwood, Gina; Perez-Ordonez, Bayardo; Irish, Jonathan C.

doi:10.1002/hed.20821

Cited by 133 publications

(214 citation statements)

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“…10-year local control rate reaches to 81-95% (Chak et al, 1987;Tsang et al, 2001;Reed et al, 2011;Sasaki et al, 2012;Suh et al, 2012). Median survival time is reported to be 7-12 years (Knowling et al, 1983;Chak et al, 1987;Frassica et al, 1989;Liebross et al, 1998;Bachar et al, 2008). However, in spite of a curative treatment, some cases progress to multiple myeloma (MM) eventually, approximately 60% in SBP (Bataille et al, 1981;Ozsahin et al, 2006;Reed et al, 2011) and 8-64% in EMP (Strojan et al, 2002;Ozsahin et al, 2006;Bachar et al, 2008;Reed et al, 2011;Suh et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

“…Median survival time is reported to be 7-12 years (Knowling et al, 1983;Chak et al, 1987;Frassica et al, 1989;Liebross et al, 1998;Bachar et al, 2008). However, in spite of a curative treatment, some cases progress to multiple myeloma (MM) eventually, approximately 60% in SBP (Bataille et al, 1981;Ozsahin et al, 2006;Reed et al, 2011) and 8-64% in EMP (Strojan et al, 2002;Ozsahin et al, 2006;Bachar et al, 2008;Reed et al, 2011;Suh et al, 2012). Once the disease becomes systemic, the prognosis is similar to patients initially diagnosed with MM, and 5-year OS decreases to 33% (Mendenhall et al, 1980).…”

Section: Introductionmentioning

confidence: 99%

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Radiotherapy Alone is Associated with Improved Outcomes Over Surgery in the Management of Solitary Plasmacytoma

Li¹,

Niu²,

Wang³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: A moderate dose of radiation is the recommended treatment for solitary plasmacytoma (SP), but there is controversy over the role of surgery. Our study aimed at comparing different treatment modalities in the management of SP. Materials and Methods: Data from 38 consecutive patients with solitary plasmacytoma, including 16 with bone plasmacytoma and 22 with extramedullary plasmacytoma, were retrospectively reviewed. 15 patients received radiotherapy alone; 11 received surgery alone, and 12 received both. The median radiation dose was 50Gy. All operations were performed as radical resections. Local progression-free survival (LPFS), multiple myeloma-free survival (MMFS), progression-free survival (PFS) and overall survival (OS) were calculated and outcomes of different therapies were compared. Results: The median follow-up time was 55 months. 5-year LPFS, MMFS, PFS and OS were 87.0%, 80.9%, 69.8% and 87.4%, respectively. Univariate analysis revealed, compared with surgery alone, radiotherapy alone was associated with significantly higher 5-year LPFS (100% vs 69.3%, p=0.016), MMFS (100% vs 51.4%, p=0.006), PFS (100% vs 33.7%, p=0.0004) and OS (100% vs 70%, p=0.041). Conclusions: Radiotherapy alone can be considered as a more effective treatment for SP over surgery. Whether a combination of radiotherapy and surgery improves outcomes requires further study.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Radiotherapy Alone is Associated with Improved Outcomes Over Surgery in the Management of Solitary Plasmacytoma

Li¹,

Niu²,

Wang³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…Rarely extramedullary plasmacytoma can occur in the thyroid, hypopharynx, larynx, parotid gland, cervical lymph nodes and middle ear. Other areas affected include gastrointestinal tract, bladder, breast, central nervous system, testis, skin, lung parenchyma and bronchus [1][2][3].…”

Section: Discussionmentioning

confidence: 99%

“…Most common malignancies of trachea are squamous cell carcinoma and adenoid cystic carcinoma. Extramedullary plasmacytoma occurring in trachea is very rare and less than 20 cases have been reported in literature [2,5]. The etiology of these lesions is not well understood but viral pathogenesis and chronic irritation are suggested to be the contributing factors [6].…”

Section: Discussionmentioning

confidence: 99%

“…Treatment options include surgery and/or radiation therapy. Extramedullary plasmacytoma respond well to radiation therapy [2,6,13]. Data from literature shows that around 60 % of patients with plasmacytoma of upper aerodigestive tract had no recurrence or progression to multiple myeloma whereas 22 % cases had recurrence and 16 % showed progression to multiple myeloma [2,3,14].…”

Section: Discussionmentioning

confidence: 99%

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Extramedullary Plasmacytoma of the Trachea

Saxena

Nair

Jacob

et al. 2013

Head and Neck Pathol

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Extramedullary plasmacytomas are plasma cell tumors that occur outside the bone marrow. They constitute around 4 % of all plasma cell neoplasms. The most common site of extramedullary plasmacytoma is the upper aerodigestive tract-nasal cavity, paranasal sinuses and oronasopharynx. We are presenting a case of extramedullary plasmacytoma of the trachea. Trachea is an extremely rare site of plasmacytoma. When extraosseous plasmacytoma occur in uncommon sites, the distinction from B cell lymphomas showing extensive plasmacytic differentiation can be difficult and diagnostically challenging.

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Radiotherapy vs Surgery for Survival and Locoregional Control of Head and Neck Extramedullary Plasmacytoma

Vasudevan,

Sayed,

Kapartiwar

et al. 2024

JAMA Otolaryngol Head Neck Surg

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ImportanceThere are significant gaps in the literature pertaining to the locoregional control and survival rates of extramedullary plasmacytoma (EMP) with respect to various treatment approaches.ObjectiveTo systematically evaluate the differences in radiotherapy and surgical outcomes in EMP.Data SourcesDatabases including PubMed, Scopus, Web of Science, Embase, and ScienceDirect were systematically searched from their inception up to November 2023.Study SelectionArticles reporting radiotherapy and surgical outcomes of head and neck EMP were included.Data Extraction and SynthesisA random-effects model for meta-analysis was used to obtain pooled estimates and calculate hazard ratios for survival and odds ratios for recurrence and progression of EMP.Main Outcomes and MeasuresSurvival, tumor control, and progression rates to multiple myeloma (MM) between radiation therapy and surgery for EMP of the head and neck.ResultsOf 742 included patients from 12 studies, 527 (71.0%) were male, and the median (IQR) age was 59.1 (53-62) years. A total of 505 patients (68.1%) received radiotherapy only, while 237 (31.9%) underwent surgery-only treatment for EMP. All included patients had an initial diagnosis of EMP without MM. Comparable trends were observed in overall survival and disease-free survival (DFS) rates at 2, 3, 5, and 10 years between patients with EMP treated with radiotherapy only and surgery only. Notably, there were no significant differences in recurrence rate (odds ratio, 0.65; 95% CI, 0.20-2.06) between radiotherapy-only and surgery-only treatment. However, radiotherapy-only treatment of EMP was associated with decreased odds of progression to MM compared with surgery (odds ratio, 0.4; 95% CI, 0.1-0.9). Sensitivity analysis revealed that the radiotherapy-only population had significantly better 5-year DFS (hazard ratio, 0.55; 95% CI, 0.31-0.96) compared with surgery-only treatment.Conclusions and RelevanceThis systematic review and meta-analysis provides evidence that patients with EMP receiving radiotherapy had significantly lower chances of progression to MM compared with surgery-only therapy. Additionally, radiotherapy had better 5-year DFS outcomes compared with surgery. Comparable outcomes in terms of overall survival rates, recurrence, and mortality rates were noted between radiotherapy-only and surgery-only EMP treatment groups.

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Solitary extramedullary plasmacytoma of the head and neck—Long‐term outcome analysis of 68 cases

Abstract: Radiation is the treatment of choice with surgery reserved for large tumors and extensive bone destruction. Long-term follow-up is essential because local recurrence and disseminated disease can occur many years postdiagnosis.

Cited by 133 publications

References 35 publications

Radiotherapy Alone is Associated with Improved Outcomes Over Surgery in the Management of Solitary Plasmacytoma

Radiotherapy Alone is Associated with Improved Outcomes Over Surgery in the Management of Solitary Plasmacytoma

Extramedullary Plasmacytoma of the Trachea

Radiotherapy vs Surgery for Survival and Locoregional Control of Head and Neck Extramedullary Plasmacytoma

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