PURPOSE: To review the histories of extramedullary plasmacytoma @entity1 diagnosed in Slovenia between 1969 and 1999, to determine the relationship between radiotherapy (XRT) dose and @entity5 control, and to clarify the role of elective nodal XRT and the prognostic value of Bartl's histologic grading criteria (originally devised for @entity1582 [ @entity1582 ]). METHODS AND MATERIALS: The database of the Cancer Registry of Slovenia was used for the identification of @entity1 . The inclusion criteria were as follows: bone marrow biopsy showing less than 10% plasma cells, normal skeletal survey, and immunohistochemically determined @entity5 monoclonality. Simulation/portal films were reviewed to assess the extent of elective nodal XRT. RESULTS: Twenty-six @entity1 with 31 @entity5 fulfilled the inclusion criteria. In 4 @entity1 , nine metachronously appearing solitary @entity5 were diagnosed. The head-and-neck region and other body sites were the sites of origin of primary @entity5 in 84% and 16% of @entity1 , respectively, whereas in the two regions, regional disease was seen in 15% and 60% of @entity1 , respectively. Therapy was as follows: XRT, 12 @entity1 ; surgery and postoperative XRT, 15 @entity1 ; and surgery, 4 @entity1 . Ultimate local and regional control rates were 90% and 97%, respectively, and @entity1582 developed in 2 (8%) @entity1 . The 10-year disease-specific and overall survival rates were 87% and 61%, respectively. The analysis of the dose-effect relationship showed that more conservative treatment is justified: for macroscopic disease, 40-50 Gy (2 Gy/day), adjusted to the bulk of disease; for microscopic disease, 36-40 Gy; after R0 surgery, no XRT is required, but close observation is needed. No attempts should be made to treat uninvolved nodal regions. Using Bartl's histologic grading criteria, trends were detected in @entity1 with higher @entity5 grades: regional lymph node involvement (p = 0.04) and shorter disease-specific survival (p = 0.08). CONCLUSIONS: @entity8709 is a highly curable disease when XRT is used with or without previous surgery. The rate of conversion to @entity1582 is low. Moderate-dose XRT using limited fields is recommended. The prognostic value of Bartl's grading system needs further evaluation.

XXXX : clinical and histopathologic study.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1582 :: ('MESH:D009101', 'Disease') :: ['multiple myeloma', 'MM'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'local tumor', 'tumors'] @entity8709 :: ('MESH:C537514', 'Disease') :: ['Extramedullary plasmacytoma']
@entity8709 :: (MESH:C537514,Disease) :: ['Extramedullary plasmacytoma']
