title: Treatment and outcomes for primary cutaneous extramedullary plasmacytoma: a case series.
abstract: BACKGROUND
  Primary cutaneous plasmacytoma (pcp) is a rare disease, with few studies to guide therapy. Our primary study objective was to define treatments used for pcp; a secondary objective was to describe outcomes of patients, including disease recurrence and death.
  
  
  METHODS
  An institutional cancer registry was used to identify cases for retrospective chart review. In a systematic review, treatments for, and outcomes of, all known cases of pcp were described.
  
  
  RESULTS
  Three eligible cases identified at our institution; each patient had a solitary pcp. The systematic review identified 66 patients. Radiotherapy was the most commonly used primary treatment modality (31% of all patients; 42% for patients with solitary lesions), followed by surgery (28% of all patients; 36% for patients with solitary lesions). Median survival for all patients was 10.4 years [95% ci: 4.3 years to not reached], with a trend toward a decreased risk of death with solitary lesions compared with multiple lesions (hazard ratio: 0.37; 95% ci: 0.13 to 1.08;p= 0.059). For patients with solitary lesions, the median and recurrence-free survivals were, respectively, 17.0 years (95% ci: 1.7 years to not reached) and 11.0 years (95% ci: 2 years to not reached); for patients with multiple lesions, they were 4.3 years (95% ci: 1.3 to not reached) and 1.4 years (95% ci: 0.6 years to not reached). Disease recurrence, including progression to multiple myeloma, was the most common cause of death.
  
  
  CONCLUSIONS
  Compared with patients having multiple pcp lesions, those presenting with a single pcp lesion might experience longer overall survival. Local therapy (radiation or surgery) is a reasonable curative treatment for a solitary pcp lesion.
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, and Department of Radiation Oncology, University of Toronto.
authors.forename: D S
authors.initials: DS
authors.lastname: Tsang
authors.affiliation: Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network; and.
authors.forename: L W
authors.initials: LW
authors.lastname: Le
authors.affiliation: Division of Hematology/Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON.
authors.forename: V
authors.initials: V
authors.lastname: Kukreti
authors.affiliation: Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, and Department of Radiation Oncology, University of Toronto.
authors.forename: A
authors.initials: A
authors.lastname: Sun
keywords: Chemotherapy; plasmacytoma; radiotherapy; skin; surgery