Chest wall infiltration is a critical prognostic factor in breast implant-associated anaplastic large-cell lymphoma affected patients.


Journal

European journal of cancer (Oxford, England : 1990)
ISSN: 1879-0852
Titre abrégé: Eur J Cancer
Pays: England
ID NLM: 9005373

Informations de publication

Date de publication:
05 2021
Historique:
received: 27 10 2020
revised: 19 01 2021
accepted: 28 01 2021
pubmed: 26 3 2021
medline: 26 10 2021
entrez: 25 3 2021
Statut: ppublish

Résumé

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. 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. 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. 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.

Sections du résumé

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.

Identifiants

pubmed: 33765512
pii: S0959-8049(21)00077-0
doi: 10.1016/j.ejca.2021.01.041
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

277-286

Informations de copyright

Copyright © 2021 Elsevier Ltd. All rights reserved.

Auteurs

Antonella Campanale (A)

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.

Arianna Di Napoli (A)

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.

Marco Ventimiglia (M)

Directorate General of Medical Device and Pharmaceutical Service - Italian Ministry of Health, Rome, Italy.

Stefano Pileri (S)

Group of Experts on BIA-ALCL at the Italian Ministry of Health, Italy; Haematopathology Division, IEO, European Institute of Oncology IRCCS, Milan, Italy.

Daniela Minella (D)

Directorate General of Medical Device and Pharmaceutical Service - Italian Ministry of Health, Rome, Italy.

Giuseppe Curigliano (G)

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.

Maurizio Martelli (M)

Group of Experts on BIA-ALCL at the Italian Ministry of Health, Italy; Department of Translational and Precision Medicine "Sapienza" University, Rome, Italy.

Roy De Vita (R)

Group of Experts on BIA-ALCL at the Italian Ministry of Health, Italy; Plastic Surgery Department, National Institute for Cancer, Rome, Italy.

Paola Di Giulio (P)

Group of Experts on BIA-ALCL at the Italian Ministry of Health, Italy; Department of Public Health and Paediatrics, Turin University, Italy.

Marco Montorsi (M)

Group of Experts on BIA-ALCL at the Italian Ministry of Health, Italy; Humanitas University and Humanitas Research Center, IRCCS, Milan, Italy.

Paolo Veronesi (P)

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.

Silvia Giordano (S)

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.

Achille Iachino (A)

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.

Lucia Lispi (L)

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.

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