Epidemiologic Evidence of Superior Outcomes for Extramedullary Plasmacytoma of the Head and Neck

Gerry, Daniel; Lentsch, Eric J.

doi:10.1177/0194599813481334

Cited by 63 publications

(75 citation statements)

References 17 publications

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“…But interestingly, for upper aerodigestive tract EMP, higher OS and RFS were detected in those received surgery+RT (Alexiou et al, 1999). More recently, Gerry et al reported EMP in the head & neck area responded better to surgery than RT or surgery+RT (Gerry et al, 2013), while some researcher held a contrary opinion (Michalaki et al, 2003;Creach et al, 2009). To be noticed, it is not always possible to remove an EMP completely, especially in the head & neck area due to the adjacent vital organs structures, highlighting the importance of lesion location in treatment planning.…”

Section: Discussionmentioning

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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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: Discussionmentioning

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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“…For extraosseous plasmacytomas, primary treatment is RT (>30 Gy to the involved field) 51 to the involved field followed by surgery 57 if necessary.…”

Section: Solitary Plasmacytomamentioning

confidence: 99%

Multiple Myeloma, Version 2.2016

Anderson¹,

Alsina²,

Atanackovic³

et al. 2015

J Natl Compr Canc Netw

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Multiple myeloma (MM) is a malignant neoplasm of plasma cells that accumulate in bone marrow, leading to bone destruction and marrow failure. Recent statistics from the American Cancer Society indicate that the incidence of MM is increasing. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) included in this issue address management of patients with solitary plasmacytoma and newly diagnosed MM.

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“…In another case series of 18 patients from Mayo Clinic showed that all EMP of the head and neck treated, median OS was 12.5 years with 5-year and 10-year survival rates of 88% and 55%, respectively, six patients developed MM or plasmacytoma at a distant site 12. In addition, an analysis of the Surveillance, Epidemiology, and End Results database that included 1185 patients with EMP reported superior median survival among patients with involvement of the head and neck when compared with patients with other sites of EMP (13 vs 4 years) 10. So, there can be three patterns of failure namely local recurrence, development of MM and development of new lesions without MM 13.…”

Section: Discussionmentioning

confidence: 99%

“…So, it is considerable to offer adjuvant radiation therapy to achieve local control whenever there is doubt of local residual disease. The literature reveals that patients with head and neck plasmacytoma have better prognosis than those with plasmacytoma elsewhere in the body 10. Since parotid EMP itself is a rare entity, presently, there is no literature available to guide us regarding overall survival (OS) and recurrence-free survival.…”

Section: Discussionmentioning

confidence: 99%

Extramedullary plasmacytoma: rare neoplasm of parotid gland

Abrar¹,

Nasir

Qureshi

et al. 2018

BMJ Case Reports

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A 45-year-old man presented with left-sided facial swelling. Initial excisional biopsy was done somewhere else without prior imaging and it came out to be pleomorphic adenoma; local imaging after biopsy showed mass over the left parotid gland with ipsilateral lymphadenopathy. On examination, there was a well-circumscribed mass with signs of left facial nerve palsy. He underwent left radical parotidectomy with ipsilateral modified radical neck dissection, and per operatively, it came out to be neoplastic lesion. Final histopathology was plasma cell neoplasm of the parotid gland. After surgery, the patient received radiation therapy to the left parotid region on account of uncertain surgical margins. It has been 3 years down the road that there is no evidence of local recurrence or transformation into multiple myeloma. Available evidence reveals that mere surgery for extramedullary plasmacytoma is not enough for local control whenever there is doubt of residual disease consider radiation therapy.

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Epidemiologic Evidence of Superior Outcomes for Extramedullary Plasmacytoma of the Head and Neck

Abstract: Extramedullary plasmacytoma of the head and neck represents a type of tumor unique from other plasmacytomas, with distinct epidemiologic characteristics and a superior prognosis. Evidence suggests that surgically based treatments may offer improved outcomes.

Cited by 63 publications

References 17 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

Multiple Myeloma, Version 2.2016

Extramedullary plasmacytoma: rare neoplasm of parotid gland

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