title: Primary Cutaneous B-Cell Lymphoma: Management and Patterns of Recurrence at the Multimodality Cutaneous Lymphoma Clinic of The Ohio State University.
abstract: BACKGROUND
  The increasing incidence of primary cutaneous B-cell lymphomas (PCBCLs) presents new challenges for clinicians. Despite advances in the clinical and pathologic characterization of PCBCL, the significance of the current staging approach as a risk profiling tool and the effect of various treatments on outcome remain unclear.
  
  
  METHODS
  We retrospectively reviewed patients who presented with a diagnosis of PCBCL seen at The Ohio State University between 1998 and 2012. We reviewed the initial presentation and treatment modality. We then assessed whether the treatment modality (conservative skin-directed vs. definitive radiation with or without systemic therapy), stage (T1 or ≥T2), or histologic subtype (primary cutaneous follicle center lymphoma [PCFCL] vs. primary cutaneous marginal zone B-cell lymphoma [PCMZL]) affected the risk of recurrence.
  
  
  RESULTS
  We identified 67 patients referred with an initial diagnosis of PCBCL. After imaging, 12 did not meet the criteria for PCBCL and were classified as having systemic B-cell lymphoma with cutaneous involvement. The remaining 55 patients included 25 with PCMZL, 24 with PCFCL, 2 with primary cutaneous large B-cell lymphoma leg type, and 4 with unclassifiable disease. According to the International Society of Cutaneous Lymphoma-European Organization for Research and Treatment of Cancer staging, 30 cases were T1 (55%), 14 T2 (25%), and 11 T3 (20%). Comparing the time to first recurrence (TFR) by indolent PCBCL subtypes, we found no difference in the recurrence risk for either stage (T1, p = .51 vs. T2/T3, p = .30). Comparing TFR by treatment modality, we found no difference in TFR within T1 patients (p = .34) or T2/T3 patients (p = .44).
  
  
  CONCLUSIONS
  Our limited analysis highlights the importance of complete staging at diagnosis and suggests that the treatment modality does not affect the risk of recurrence in T1 indolent PCBCL.
authors: Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA pierluigi.porcu@osumc.edu bradley.haverkos@ucdenver.edu.
authors: Brad
authors: B
authors: Haverkos
authors: Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA.
authors: Kelly
authors: K
authors: Tyler
authors: Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA.
authors: Alejandro A
authors: AA
authors: Gru
authors: Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA.
authors: Francisca Kartono
authors: FK
authors: Winardi
authors: Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA.
authors: Julie
authors: J
authors: Frederickson
authors: Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA.
authors: Justin
authors: J
authors: Hastings
authors: Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA.
authors: Camille
authors: C
authors: Elkins
authors: Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA.
authors: Xiaoli
authors: X
authors: Zhang
authors: Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA.
authors: Meng
authors: M
authors: Xu-Welliver
authors: Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA.
authors: Henry K
authors: HK
authors: Wong
authors: Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA pierluigi.porcu@osumc.edu bradley.haverkos@ucdenver.edu.
authors: Pierluigi
authors: P
authors: Porcu
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000473:pathology* / Q000628:therapy*; D018442:Lymphoma, B-Cell, Marginal Zone / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009820:Ohio; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology* / Q000628:therapy*; D016896:Treatment Outcome
keywords: B-cell lymphoma; Follicle center lymphoma; Marginal zone lymphoma; Neoplasm recurrence; Skin neoplasms