Zahra Ghiassi-Nejad1, Meng Ru2, Erin Moshier2, Sanders Chang3, Sundar Jagannath4, Kavita Dharmarajan3. 1. Department of Radiation Oncology, Mount Sinai Hospital, New York, NY. Electronic address: zahra.ghiassi@mountsinai.org. 2. Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY. 3. Department of Radiation Oncology, Mount Sinai Hospital, New York, NY. 4. Department of Hematology and Oncology, Mount Sinai Hospital, New York, NY.
Abstract
BACKGROUND: Given the rarity of plasmacytoma, large-scale database analysis can provide useful information regarding the clinical presentation and patient-related factors impacting overall survival (OS). MATERIALS AND METHODS: The National Cancer Data Base was queried for patients with plasmacytoma between 2004 and 2013, excluding patients with systemic disease. Plasmacytomas were classified as originating in bone (P-bone), in extramedullary tissue (P-EM), or unspecified. Survival was estimated using the Kaplan-Meier and log-rank test method. We used Cox regression to determine specific outcomes adjusting for demographic, socioeconomic, geographic, facility type, year of diagnosis, and comorbid factors. RESULTS: In total, 6225 patients were identified, of which 61.5% were men. The median age at diagnosis was 64 years (range, 18-90 years), and the median follow-up was 58 months. The primary site of disease was P-bone in 4056 (65.1%) patients and P-EM in 1468 (23.6%), and the remaining 701 patients were P-unspecified. The unadjusted median survival for solitary P-bone was 89 months (95% confidence interval, 82.9-95.0 months), and for solitary P-EM was 117.3 months (95% confidence interval, 108.8 months to not reached). Factors associated with improved OS include younger age, private insurance, higher income, solitary lesion, and lower comorbidity score. Patients with P-bone disease treated at academic facilities had improved OS. Only 65% of patients with solitary plasmacytoma lesions received radiation treatment. Age greater than 75 years and increased distance to treatment facility was associated with a decreased likelihood of receiving radiation. CONCLUSIONS: This is the largest study examining outcomes of patients with plasmacytoma using a large database analysis, revealing unique aspects of P-EM versus P-bone and underutilization of radiation treatment.
BACKGROUND: Given the rarity of plasmacytoma, large-scale database analysis can provide useful information regarding the clinical presentation and patient-related factors impacting overall survival (OS). MATERIALS AND METHODS: The National Cancer Data Base was queried for patients with plasmacytoma between 2004 and 2013, excluding patients with systemic disease. Plasmacytomas were classified as originating in bone (P-bone), in extramedullary tissue (P-EM), or unspecified. Survival was estimated using the Kaplan-Meier and log-rank test method. We used Cox regression to determine specific outcomes adjusting for demographic, socioeconomic, geographic, facility type, year of diagnosis, and comorbid factors. RESULTS: In total, 6225 patients were identified, of which 61.5% were men. The median age at diagnosis was 64 years (range, 18-90 years), and the median follow-up was 58 months. The primary site of disease was P-bone in 4056 (65.1%) patients and P-EM in 1468 (23.6%), and the remaining 701 patients were P-unspecified. The unadjusted median survival for solitary P-bone was 89 months (95% confidence interval, 82.9-95.0 months), and for solitary P-EM was 117.3 months (95% confidence interval, 108.8 months to not reached). Factors associated with improved OS include younger age, private insurance, higher income, solitary lesion, and lower comorbidity score. Patients with P-bone disease treated at academic facilities had improved OS. Only 65% of patients with solitary plasmacytoma lesions received radiation treatment. Age greater than 75 years and increased distance to treatment facility was associated with a decreased likelihood of receiving radiation. CONCLUSIONS: This is the largest study examining outcomes of patients with plasmacytoma using a large database analysis, revealing unique aspects of P-EM versus P-bone and underutilization of radiation treatment.
Authors: Ronald S Go; Adam C Bartley; Cynthia S Crowson; Nilay D Shah; Elizabeth B Habermann; Sara J Holton; David R Holmes Journal: J Clin Oncol Date: 2016-10-23 Impact factor: 44.544
Authors: Valerie Reed; Jatin Shah; L Jeffery Medeiros; Chul S Ha; Ali Mazloom; Donna M Weber; Isidora Y Arzu; Robert Z Orlowski; Sheeba K Thomas; Ferial Shihadeh; Raymond Alexanian; Bouthaina S Dabaja Journal: Cancer Date: 2011-03-22 Impact factor: 6.860
Authors: Mahmut Ozsahin; Richard W Tsang; Philip Poortmans; Yazid Belkacémi; Michel Bolla; Fazilet Oner Dinçbas; Christine Landmann; Bernard Castelain; Jeroen Buijsen; Jürgen Curschmann; Sidney P Kadish; Anna Kowalczyk; Yavuz Anacak; Josef Hammer; Tan D Nguyen; Gabriela Studer; Rachel Cooper; Meriç Sengöz; Luciano Scandolaro; Abderrahim Zouhair Journal: Int J Radiat Oncol Biol Phys Date: 2005-10-17 Impact factor: 7.038
Authors: P Galieni; M Cavo; G Avvisati; A Pulsoni; R Falbo; M A Bonelli; D Russo; M T Petrucci; A Bucalossi; S Tura Journal: Ann Oncol Date: 1995-09 Impact factor: 32.976
Authors: Graça M Dores; Ola Landgren; Katherine A McGlynn; Rochelle E Curtis; Martha S Linet; Susan S Devesa Journal: Br J Haematol Date: 2008-11-11 Impact factor: 6.998