title: Epidemiologic evidence of superior outcomes for extramedullary plasmacytoma of the head and neck.
abstract: OBJECTIVE
  To compare clinicopathologic data, epidemiologic factors, and survival outcomes between extramedullary plasmacytomas of the head and neck vs other body sites.
  
  
  METHODS
  Analysis of a national database.
  
  
  METHODS
  Extramedullary plasmacytoma (EMP) is a rare B-cell neoplasm with a tendency to occur in the head and neck. Due to limited clinical data, few studies have conducted a thorough comparison between head and neck EMPs and those arising at other body sites.
  
  
  METHODS
  We compared 690 EMPs of the head and neck with 495 non-head and neck EMPs, evaluating disease-specific survival (DSS) and overall survival (OS) based on tumor type, location, grade, stage, and treatment.
  
  
  RESULTS
  Head and neck EMPs more often affected men (P > .001) and were typically located in the pharynx (21.5%), nasal cavity (19.3%), oral cavity (14.7%), and paranasal sinuses (13.0%). Non-head and neck EMPs were more often limited to only local disease at presentation (94.8% vs 82.1%-86.7%, P < .001). Patients with non-head and neck EMP more often received surgery alone, whereas those with head and neck EMP were more often treated with combination therapy or radiation alone (P < .001). Head and neck EMPs had a significantly higher 5-year DSS and OS than other plasmacytomas (P < .001), and they had a higher 10-year OS when treated with surgery or combination therapy than with radiation alone (P = .003).
  
  
  CONCLUSIONS
  Extramedullary plasmacytoma of the head and neck represents a type of tumor unique from other plasmacytomas, with distinct epidemiologic characteristics and a superior prognosis. Evidence suggests that surgically based treatments may offer improved outcomes.
authors.affiliation: Mercer University School of Medicine, Savannah, Georgia, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Gerry
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Lentsch
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002648:Child; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010954:Plasmacytoma / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy*; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012042:Registries; D018426:SEER Program; D012737:Sex Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: SEER database; extramedullary plasmacytoma; head and neck; solitary bone plasmacytoma