Antonella Campanale1, Arianna Di Napoli2, Marco Ventimiglia3, Stefano Pileri4, Daniela Minella3, Giuseppe Curigliano5, Maurizio Martelli6, Roy De Vita7, Paola Di Giulio8, Marco Montorsi9, Paolo Veronesi10, Silvia Giordano11, Achille Iachino1, Lucia Lispi1. 1. Directorate General of Medical Device and Pharmaceutical Service - Italian Ministry of Health, Rome, Italy; Group of Experts on BIA-ALCL at the Italian Ministry of Health, Italy. 2. Group of Experts on BIA-ALCL at the Italian Ministry of Health, Italy; Department of Clinical and Molecular Medicine, Sapienza University, Sant'Andrea Hospital, Rome, Italy. 3. Directorate General of Medical Device and Pharmaceutical Service - Italian Ministry of Health, Rome, Italy. 4. Group of Experts on BIA-ALCL at the Italian Ministry of Health, Italy; Haematopathology Division, IEO, European Institute of Oncology IRCCS, Milan, Italy. 5. Group of Experts on BIA-ALCL at the Italian Ministry of Health, Italy; Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Haemato-Oncology, University of Milano, Milan, Italy. Electronic address: giuseppe.curigliano@ieo.it. 6. Group of Experts on BIA-ALCL at the Italian Ministry of Health, Italy; Department of Translational and Precision Medicine "Sapienza" University, Rome, Italy. 7. Group of Experts on BIA-ALCL at the Italian Ministry of Health, Italy; Plastic Surgery Department, National Institute for Cancer, Rome, Italy. 8. Group of Experts on BIA-ALCL at the Italian Ministry of Health, Italy; Department of Public Health and Paediatrics, Turin University, Italy. 9. Group of Experts on BIA-ALCL at the Italian Ministry of Health, Italy; Humanitas University and Humanitas Research Center, IRCCS, Milan, Italy. 10. Group of Experts on BIA-ALCL at the Italian Ministry of Health, Italy; Department of Oncology and Haemato-Oncology, University of Milano, Milan, Italy; Division of Breast Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy. 11. Group of Experts on BIA-ALCL at the Italian Ministry of Health, Italy; Department of Oncology, University of Torino and Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy.
Abstract
BACKGROUND: Breast implant-associated anaplastic large-cell lymphoma is a rare disease with a favourable prognosis if adequately treated. Same staged patients have usually a similar prognosis and outcomes, but in our experience, IIA-staged patients have a wider prognosis with outcomes that vary from complete disease response to death. This study aimed to understand and identify all the factors that could influence the prognosis of this group of patients and verify if their prognosis matches the stage they belong to. MATERIAL AND METHODS: Patients in stage IIA have been divided into two subgroups: IIAb with lymphoma extension towards the glandular tissue and IIAcw with tumour extension towards the chest-wall. The overall survival (OS) and event-free survival (EFS) of 64 BIA-ALCL cases were evaluated for each staged group. RESULTS: Significant differences of OS and EFS between IIAb and IIAcw patients (log-rank p = 0.046 and log-rank p = 0.018, respectively) were observed and poor prognosis joined IIAcw- and IV-staged patients. CONCLUSION: Chest-wall infiltration is a critical prognostic factor in BIA-ALCL patients as it influences the possibility of performing a surgical radical tumour extirpation. Our results could represent valid assistance for the physicians in choosing the most appropriate BIA-ALCL prognostic category and treatment and could promote further wider studies to provide stronger evidence on a possible revision of the MDA TNM classification.
BACKGROUND: Breast implant-associated anaplastic large-cell lymphoma is a rare disease with a favourable prognosis if adequately treated. Same staged patients have usually a similar prognosis and outcomes, but in our experience, IIA-staged patients have a wider prognosis with outcomes that vary from complete disease response to death. This study aimed to understand and identify all the factors that could influence the prognosis of this group of patients and verify if their prognosis matches the stage they belong to. MATERIAL AND METHODS:Patients in stage IIA have been divided into two subgroups: IIAb with lymphoma extension towards the glandular tissue and IIAcw with tumour extension towards the chest-wall. The overall survival (OS) and event-free survival (EFS) of 64 BIA-ALCL cases were evaluated for each staged group. RESULTS: Significant differences of OS and EFS between IIAb and IIAcw patients (log-rank p = 0.046 and log-rank p = 0.018, respectively) were observed and poor prognosis joined IIAcw- and IV-staged patients. CONCLUSION: Chest-wall infiltration is a critical prognostic factor in BIA-ALCL patients as it influences the possibility of performing a surgical radical tumour extirpation. Our results could represent valid assistance for the physicians in choosing the most appropriate BIA-ALCL prognostic category and treatment and could promote further wider studies to provide stronger evidence on a possible revision of the MDA TNM classification.
Authors: Sarah Premji; Andreia Barbieri; Christine Roth; Eric M Rohren; Gustavo Rivero; Sravanti P Teegavarapu Journal: Case Rep Hematol Date: 2022-06-09