Breast implant-associated anaplastic large-cell lymphoma (BI-ALCL) is a rare type of T-cell lymphoma that arises around breast implants. The optimal management of this disease has not been established. The goal of this study is to evaluate the efficacy of different therapies used in patients with BI-ALCL to determine an optimal treatment approach. Patients and MethodsIn this study, we applied strict criteria to pathologic findings, assessed therapies used, and conducted a clinical follow-up of 87 patients with BI-ALCL, including 50 previously reported in the literature and 37 unreported. A Prentice, Williams, and Peterson model was used to assess the rate of events for each therapeutic intervention. ResultsThe median and mean follow-up times were 45 and 30 months, respectively (range, 3 to 217 months). The median overall survival (OS) time after diagnosis of BI-ALCL was 13 years, and the OS rate was 93% and 89% at 3 and 5 years, respectively. Patients with lymphoma confined by the fibrous capsule surrounding the implant had better event-free survival (EFS) and OS than did patients with lymphoma that had spread beyond the capsule (P = .03). Patients who underwent a complete surgical excision that consisted of total capsulectomy with breast implant removal had better OS (P = .022) and EFS (P = .014) than did patients who received partial capsulectomy, systemic chemotherapy, or radiation therapy. ConclusionSurgical management with complete surgical excision is essential to achieve optimal EFS in patients with BI-ALCL.

Conclusion:Patients have responded positively to new pandemic-related policies in our radiotherapy department and report overall satisfaction with their care. While patient satisfaction is high, the pandemic has resulted in decreased morale and the perception of increased workload among healthcare workers. Results from this study have been used to identify barriers to workplace satisfaction and have led to implementation of changes. This study highlights the importance of seeking feedback from both patients and healthcare workers to understand the complexities at play in preserving the quality of patient care and the work environment as we continue to work in the current reality.

This study evaluated the survival benefit of asparaginase (ASP)-based versus non-ASP-based regimens in a real-world cohort of patients with early-stage extranodal nasal-type NK/T-cell lymphoma (ENKTCL). Materials/Methods: In the modern era, we identified 376 patients who received combined radiotherapy with either ASP-based (asparaginase, platinum and gemcitabine, n = 286) or non-ASP-based (platinum and gemcitabine, n = 90) regimens. The patients were stratified into low-, intermediate-and high-risk groups using the early stage-adjusted nomogramrevised risk index (ES-NRI). Overall survival (OS) and distant metastasis (DM)-free survival (DMFS) between the chemotherapy regimens were compared using inverse probability of treatment weighting (IPTW) and multivariable analyses. Results: ASP-based (versus non-ASP-based) regimens significantly improved 5-year OS (84.5% vs. 73.2%, P = 0.021) and DMFS (84.4% vs. 74.5%, P = 0.014) for intermediate-and high-risk patients, but not for lowrisk patients. Moreover, ASP-based regimens decreased DM, with 5-year cumulative DM rate of 14.9% for ASP-based regimens compared with 25.1% (P = 0.014) for non-ASP-based regimens. The survival benefit of ASP-based regimens remained consistent after adjusting the confounding variables by IPTW and multivariate analyses. Additional sensitivity analyses confirmed these results. Conclusion: These findings provide an evidence supporting ASP-based regimens as a first-line combined-modality treatment for intermediate-and high-risk early-stage ENKTCL.

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