Analysis of the Treatment and Survival of Sinonasal Extramedullary Plasmacytoma.

Autor:	Gao J; Department of Otolaryngology - Head and Neck Surgery, 12286Rutgers New Jersey Medical School, Newark, New Jersey, USA., Tseng CC; Department of Otolaryngology - Head and Neck Surgery, 12286Rutgers New Jersey Medical School, Newark, New Jersey, USA., Barinsky GL; Department of Otolaryngology - Head and Neck Surgery, 12286Rutgers New Jersey Medical School, Newark, New Jersey, USA., Fang CH; Department of Otorhinolaryngology - Head and Neck Surgery, 2013Montefiore Medical Center, The University Hospital of Albert Einstein College of Medicine, Bronx, New York, USA., Grube JG; Division of Otolaryngology/ Head and Neck Surgery, Department of Surgery, 138207Albany Medical Center, Albany, New York, USA., Hsueh WD; Department of Otolaryngology - Head and Neck Surgery, 12286Rutgers New Jersey Medical School, Newark, New Jersey, USA.; Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, 12286Rutgers New Jersey Medical School, Newark, New Jersey, USA., Baredes S; Department of Otolaryngology - Head and Neck Surgery, 12286Rutgers New Jersey Medical School, Newark, New Jersey, USA.; Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, 12286Rutgers New Jersey Medical School, Newark, New Jersey, USA., Eloy JA; Department of Otolaryngology - Head and Neck Surgery, 12286Rutgers New Jersey Medical School, Newark, New Jersey, USA.; Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, 12286Rutgers New Jersey Medical School, Newark, New Jersey, USA.; Department of Neurological Surgery, 12286Rutgers New Jersey Medical School, Newark, New Jersey, USA.; Department of Ophthalmology and Visual Science, 12286Rutgers New Jersey Medical School, Newark, New Jersey, USA.; Department of Otolaryngology and Facial Plastic Surgery, Saint Barnabas Medical Center - RWJBarnabas Health, Livingston, New Jersey, USA.
Jazyk:	angličtina
Zdroj:	American journal of rhinology & allergy [Am J Rhinol Allergy] 2022 Sep; Vol. 36 (5), pp. 591-598. Date of Electronic Publication: 2022 Apr 19.
DOI:	10.1177/19458924221092529
Abstrakt:	Background: While extramedullary plasmacytomas are infrequently encountered plasma cell malignancies, most cases occur in the head and neck, with a predilection for the sinonasal cavity. Due to the rarity of this disease, the majority of studies on sinonasal extramedullary plasmacytoma (SN-EMP) are case reports or small retrospective case series. Objective: To investigate the impact of patient, disease, and treatment factors on the survival of patients with SN-EMP. Methods: The National Cancer Database was queried for all patients with SN-EMP between 2004-2016 (N = 381 cases). Univariate and multivariate analyses were used to examine patient demographics, tumor characteristics, and survival. Results: The majority of SN-EMP patients were over 60 years old (57.0%), male (69.8%), and white (86.2%). The most common treatment modality was radiotherapy alone (38.6%), followed by surgery plus radiotherapy (37.8%). Five-year overall survival was 74.0% and median survival was 9.1 years. Accounting for patient demographics and tumor characteristics in a multivariate model, the following groups had worse prognosis: 60 and older (HR 1.99, p = 0.031) and frontal sinus primary site (HR 11.56, p = 0.001). Patients who received no treatment (HR 3.89, p = 0.013), chemotherapy alone (HR 5.57, p = 0.008) or radiotherapy plus chemotherapy (HR 2.82, p = 0.005) had significantly lower survival than patients who received radiotherapy alone. Patients who received surgery with radiotherapy (HR 0.57, p = 0.039) had significantly higher survival than patients who received radiotherapy alone. Conclusion: In patients with SN-EMP five-year overall survival was found to be 74.0% with decreased survival associated with a frontal sinus primary site and being aged 60 or older. Patients receiving no treatment, chemotherapy alone, or radiotherapy with chemotherapy was associated with lower survival. Receiving surgery plus radiotherapy was associated with the highest five-year overall survival.
Databáze:	MEDLINE
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