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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

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Abstract

Introduction

Head and neck extramedullary plasmacytoma is a rare localized plasma cell neoplasm. We intended to perform this review of the published literature to assess the demographic profile, pattern of care and survival outcomes.

Methods

Two authors independently searched PubMed, Google search and Cochrane library for eligible studies from 1950 till July 1, 2016, published in English language.

Results

Median age of the cohort was 57 years (range 11–85). Site-wise distributions were paranasal sinuses 22.3% (70), nasal cavity 17.5% (55), nasopharynx 10.8% (34). Median size of SEMP was 3 cm (range 0.3–12 cm). Treatment distribution was radiotherapy (RT) in 52% (164), surgery (S) 19% (60), chemotherapy (C) 5% (16), S + RT 23.49% (74),CRT 1.9% (6), S + C 0.6% (2), S + RT + C 0.95% (3).Radiation was used as a modality in 78.4%(247), surgery in 44.1%(139), chemotherapy in 4.8%(15). Median radiation dose used was 45 Gy with range 20–61 Gy. Median overall survival (OS) was 40 months (range 0.5–298). Median local progression-free survival was 36 months (range 0–298). Median myeloma relapse-free survival was 36 months (range 0.5–298). Five- and 10-year OS was 78.33 and 68.61%. Five-year cause-specific survival (CSS) and 10-year CSS was 90.15 and 83.31%. Five-year LPFS was 94.78%, and 10-year LPFS was 88.43%. Five-year myeloma progression-free survival was 84.46%, and 10-year myeloma PFS was 80.44%. The factors associated with risk of local relapse were site of disease (sinonasal), secretory EMP, type of treatment received (surgery + RT > RT alone > surgery on univariate analysis). Risk factors for myeloma relapse were coexisting diseases, site of disease (sinonasal), bony erosion, size of lesion > 5 cm and type of treatment received on univariate analysis.

Conclusion

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.

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References

  1. Mendenhall WM, Mendenhall CM, Mendenhall NP (2003) Solitary plasmacytoma of bone and soft tissues. Am J Otolaryngol 24(6):395–399

    Article  PubMed  Google Scholar 

  2. Pahor AL (1977) Extramedullary plasmacytoma of the head and neck, parotid and submandibular salivary glands. J Laryngol Otol 91(3):241–258

    Article  CAS  PubMed  Google Scholar 

  3. Susnerwala SS, Shanks JH, Banerjee SS, Scarffe JH, Farrington WT, Slevin NJ (1997) Extramedullary plasmacytoma of the head and neck region: clinicopathological correlation in 25 cases. Br J Cancer 75(6):921–927

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Knowling MA, Harwood AR, Bergsagel DE (1983) Comparison of extramedullary plasmacytomas with solitary and multiple plasma cell tumors of bone. J Clin Oncol Off J Am Soc Clin Oncol 1(4):255–262

    Article  CAS  Google Scholar 

  5. Ozsahin M, Tsang RW, Poortmans P, Belkacémi Y, Bolla M, Dinçbas FO et al (2006) Outcomes and patterns of failure in solitary plasmacytoma: a multicenter Rare Cancer Network study of 258 patients. Int J Radiat Oncol Biol Phys 1(1):210–217 64(

    Article  Google Scholar 

  6. Liebross RH, Ha CS, Cox JD, Weber D, Delasalle K, Alexanian R (1999) Clinical course of solitary extramedullary plasmacytoma. Radiother Oncol J Eur Soc Ther Radiol Oncol 52(3):245–249

    Article  CAS  Google Scholar 

  7. Moher D, Liberati A, Tetzlaff J, Altman DG, Group TP (2009) Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLOS Med 6(7):e1000097

    Article  PubMed  PubMed Central  Google Scholar 

  8. Kilciksiz S, Celik OK, Pak Y, Demiral AN, Pehlivan M, Orhan O et al (2008) Clinical and prognostic features of plasmacytomas: a multicenter study of Turkish Oncology Group-Sarcoma Working Party. Am J Hematol 83(9):702–707

    Article  PubMed  Google Scholar 

  9. Li Q-W, Niu S-Q, Wang H-Y, Wen G, Li Y-Y, Xia Y-F et al (2015) Radiotherapy Alone is Associated with Improved Outcomes Over Surgery in the Management of Solitary Plasmacytoma. Asian Pac J Cancer Prev APJCP 16(9):3741–3745

    Article  PubMed  Google Scholar 

  10. Gerry D, Lentsch EJ (2013) Epidemiologic evidence of superior outcomes for extramedullary plasmacytoma of the head and neck. Otolaryngol–Head Neck Surg Off J Am Acad Otolaryngol-Head Neck Surg 148(6):974–981

    Article  Google Scholar 

  11. Tournier-Rangeard L, Lapeyre M, Graff-Caillaud P, Mege A, Dolivet G, Toussaint B et al (2006) Radiotherapy for solitary extramedullary plasmacytoma in the head-and-neck region: a dose greater than 45 Gy to the target volume improves the local control. Int J Radiat Oncol Biol Phys 64(4):1013–1017

    Article  PubMed  Google Scholar 

  12. Smedt BD, Vanderstraeten B, Reynaert N, Gersem WD, Neve WD, Thierens H (2007) The influence of air cavities within the PTV on Monte Carlo-based IMRT optimization. J Phys Conf Ser 74(1):021003

    Article  Google Scholar 

  13. Haraldsson P, Knöös T, Nyström H, Engström P (2003) Monte Carlo study of TLD measurements in air cavities. Phys Med Biol 48(18):N253–N259

    Article  PubMed  Google Scholar 

  14. Suh Y-G, Suh C-O, Kim JS, Kim S-J, Pyun HO, Cho J (2012) Radiotherapy for solitary plasmacytoma of bone and soft tissue: outcomes and prognostic factors. Ann Hematol 91(11):1785–1793

    Article  CAS  PubMed  Google Scholar 

  15. Reed V, Shah J, Medeiros LJ, Ha CS, Mazloom A, Weber DM et al (2011) Solitary plasmacytomas Cancer 117(19):4468–4474

    PubMed  Google Scholar 

  16. Galieni P, Cavo M, Avvisati G, Pulsoni A, Falbo R, Bonelli MA et al (1995) Solitary plasmacytoma of bone and extramedullary plasmacytoma: two different entities? Ann Oncol 6(7):687–691

    Article  CAS  PubMed  Google Scholar 

  17. Hill QA, Rawstron AC, Tute RM de, Owen RG (2014) Outcome prediction in solitary plasmacytoma of bone: a risk stratification model utilizing bone marrow flow cytometry and light chain analysis. Blood 124(8):1296–1299

    Article  CAS  PubMed  Google Scholar 

  18. Tsang RW, Gospodarowicz MK, Pintilie M, Bezjak A, Wells W, Hodgson DC et al (2001) Solitary plasmacytoma treated with radiotherapy: impact of tumor size on outcome. Int J Radiat Oncol Biol Phys 50(1):113–120

    Article  CAS  PubMed  Google Scholar 

  19. Strojan P, Soba E, Lamovec J, Munda A (2002) Extramedullary plasmacytoma: clinical and histopathologic study. Int J Radiat Oncol Biol Phys 53(3):692–701

    Article  PubMed  Google Scholar 

  20. Patel TD, Vázquez A, Choudhary MM, Kam D, Baredes S, Eloy JA (2015) Sinonasal extramedullary plasmacytoma: a population-based incidence and survival analysis. Int Forum Allergy Rhinol 5(9):862–869

    Article  PubMed  Google Scholar 

  21. D’Aguillo C, Soni RS, Gordhan C, Liu JK, Baredes S, Eloy JA (2014 Sinonasal extramedullary plasmacytoma: a systematic review of 175 patients. Int Forum Allergy Rhinol 4(2):156–163

    Article  PubMed  Google Scholar 

  22. Sasaki R, Yasuda K, Abe E, Uchida N, Kawashima M, Uno T et al (2012) Multi-institutional analysis of solitary extramedullary plasmacytoma of the head and neck treated with curative radiotherapy. Int J Radiat Oncol 82(2):626–634

    Article  Google Scholar 

  23. Thumallapally N, Meshref A, Mousa M, Terjanian T (2017) Solitary plasmacytoma: population-based analysis of survival trends and effect of various treatment modalities in the USA. BMC Cancer [Internet]. 2017 Jan 5 [cited 2017 Apr 16];17. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5216567/. Accessed 2017

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Authors and Affiliations

  1. Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India

    Bhanuprasad Venkatesulu, Supriya Mallick, Prashanth Giridhar & Goura K. Rath

  2. Department of Bio-Statistics, All India Institute of Medical Sciences, New Delhi, India

    Ashish Dutt Upadhyay

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  1. Bhanuprasad Venkatesulu
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  2. Supriya Mallick
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  3. Prashanth Giridhar
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  4. Ashish Dutt Upadhyay
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  5. Goura K. Rath
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Correspondence to Supriya Mallick.

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No financial support received.

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All authors declare that they have no conflict of interest.

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Venkatesulu, B., Mallick, S., Giridhar, P. et al. 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. Eur Arch Otorhinolaryngol 275, 595–606 (2018). https://doi.org/10.1007/s00405-017-4817-z

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  • DOI: https://doi.org/10.1007/s00405-017-4817-z

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