Pattern of care and impact of prognostic factors on the outcome of head and neck extramedullary plasmacytoma: a systematic review and individual patient data analysis of 315 cases

Venkatesulu, BhanuPrasad; Mallick, Supriya; Giridhar, Prashanth; Upadhyay, Ashish; Rath, Goura Kishore

doi:10.1007/s00405-017-4817-z

Cited by 27 publications

(25 citation statements)

References 25 publications

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“…El grupo de trabajo internacional de mieloma, recomienda PET/ TC como parte de la evaluación inicial de pacientes con PEM con el fin de detectar otras lesiones adicionales 9 . El PEM presenta un crecimiento esencialmente local a diferencia del subtipo plasmocitoma óseo solitario, cuya progresión a MM es mayor 5 .…”

Section: Discussionunclassified

“…recomiendan como mejor tratamiento la radioterapia, reservan- do la cirugía para las lesiones extensas o con compromiso óseo 4 . Venkatesulu y cols., en una revisión de estudios de PEM en cabeza/cuello, concluyeron que la combinación cirugía y radioterapia es superior a las terapias unimodales dado que cuando se realiza cirugía más radioterapia hay menos recidivas locales 5 . Alexiou y cols.…”

Section: Discussionunclassified

“…La radioterapia se considera la piedra angular del tratamiento. La cirugía también se ha empleado como tratamiento en un porcentaje variable de pacientes 5 . En este artículo presentamos el caso de una paciente con plasmocitoma extramedular a nivel laríngeo, y se revisan las características de esta patología.…”

Section: Introductionunclassified

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Plasmocitoma extramedular de laringe. A propósito de un caso

et al. 2020

Rev. Otorrinolaringol. Cir. Cabeza Cuello

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Section: Discussionunclassified

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Plasmocitoma extramedular de laringe. A propósito de un caso

et al. 2020

Rev. Otorrinolaringol. Cir. Cabeza Cuello

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“…2 EMPs are more common in men, with a peak incidence in the sixth decade of life. 3 In differential diagnosis, reactive processes, carcinoma, and lymphoma should be with a total dose of 54 Gy in 27 fractions. Currently, 5 months after the radiotherapy, the patient remains without progression.…”

Section: Clinical Imagementioning

confidence: 99%

“…Radiotherapy has been considered a cornerstone, but the essential role of surgical treatment has been also highlighted. 3 Surgery combined with irradiation was shown to be associated with a survival benefit when compared with either surgical treatment or radiotherapy alone. In patients with unresectable tumors, radiotherapy (at least 45 Gy) should be the treatment of choice.…”

Section: Clinical Imagementioning

confidence: 99%

Solitary extramedullary plasmacytoma of palatine tonsil – a rare albeit possible entity

Suska¹,

Małkowski²,

Halaszka³

et al. 2019

Polish Archives of Internal Medicine

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A BFIGURE 1 A, B -histopathologic analysis of biopsy specimens from the left palatine tonsil tumor: A -infiltrate composed of small and medium -sized cells with plasma cell morphology, eosinophilic cytoplasm and round nuclei with fine -grained chromatin. Some cells show a nuclear polymorphism with larger nuclei and single eosinophilic nucleoli. Hematoxylin and eosin staining, magnification ×400; B -positive immunohistochemical reaction to light ĸ chains, magnification ×100

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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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Pattern of care and impact of prognostic factors on the outcome of head and neck extramedullary plasmacytoma: a systematic review and individual patient data analysis of 315 cases

Abstract: Our study shows that combined modality S + RT is superior compared to uni-modality in preventing local recurrence. Radiation dose of 45 Gy is optimal. Nodal irradiation has no impact on local recurrence.

Cited by 27 publications

References 25 publications

Plasmocitoma extramedular de laringe. A propósito de un caso

Plasmocitoma extramedular de laringe. A propósito de un caso

Solitary extramedullary plasmacytoma of palatine tonsil – a rare albeit possible entity

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

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