Author(s)
Monica S. Trent, MD
Kelsey Roman, BS
Edward Kuan, MD MPH
Affiliation(s)
University of California;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to recognize the effective treatment options for head and neck extramedullary plasmacytoma (HN-EMP) as well as relationships between overall survival and its comparison with multiple myeloma (MM)
Objectives: To evaluate whether treatment type or tumor location affect outcomes for head and neck extramedullary plasmacytoma (HN-EMP) and to compare overall survival (OS) for HN-EMP and multiple myeloma (MM).
Study Design: Retrospective cohort study.
Methods: HN-EMP and MM data was extracted from the 2004-2017 National Cancer Database (NCDB). Statistical analysis was performed using SPSS version 27.0.
Results: 1290 patients with HN-EMP were included in our analysis. Tumors were most commonly located within the nasal cavity, nasopharynx, and paranasal sinus (45.6% of all cases). 38.4% of patients underwent surgery and radiation (SR), 38.3% underwent radiotherapy alone (R), 16.1% received only surgery (S), and 7.1% received neither treatment (N). The estimated OS at 5 years was highest for SR patients (86.8%; standard error [SE]: 1.6%), followed by S patients (82.0%; SE: 2.9%), R patients (75.1%; SE: 2.1%), and N patients (40.8%; SE: 5.9%). Differences in OS by treatment received were significant on both univariate and multivariate analysis (p<0.001). Other factors associated with better OS for HN EMP patients included age under 65 (HR= 3.41, p<0.001), median household income of at least $46,000/year (HR= 1.34, p=0.012), lack of medical comorbidities (HR=1.38, p=0.016), and presence of a single versus multiple lesions (HR= 2.19, p=0.003). Univariate analysis demonstrated superior OS for HN-EMP patients (5-year OS 78.5%; SE: 1.2%) compared to MM (46.2%; SE: 0.01%), which remained significant on multivariate regression controlling for confounders (HR= 2.95, p<0.001).
Conclusions: Treatment consisting of surgery and radiotherapy predicts improved OS for HN-EMP compared to either treatment modality alone.