Primary Cutaneous B-Cell Lymphoma: Management and Patterns of Recurrence at the Multimodality Cutaneous Lymphoma Clinic of The Ohio State University

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 stagingapproachasariskprofilingtoolandtheeffectofvarious treatments on outcome remain unclear. MaterialsandMethods.Weretrospectivelyreviewedpatients who presented with a diagnosis of PCBCL seen at The Ohio State University between 1998 and 2012. We reviewed the initialpresentationandtreatmentmodality.Wethenassessed whether the treatment modality (conservative skin-directed vs.definitiveradiationwithorwithoutsystemictherapy),stage (T1 or $T2), or histologic subtype (primary cutaneous follicle center lymphoma [PCFCL] vs. primary cutaneous marginal zoneB-celllymphoma[PCMZL])affectedtheriskofrecurrence. Results.We identified 67 patients referred with an initial diagnosisofPCBCL.Afterimaging,12didnotmeetthecriteria 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 primarycutaneouslargeB-celllymphoma legtype,and 4with unclassifiable disease. According to the International Society ofCutaneousLymphoma-EuropeanOrganizationforResearch andTreatmentofCancerstaging,30caseswereT1(55%),14T2 (25%),and11T3(20%).Comparingthetimetofirstrecurrence (TFR) by indolent PCBCL subtypes, we found no difference in therecurrenceriskforeitherstage(T1,p5.51vs.T2/T3,p5.30). Comparing TFR by treatment modality, we found no difference in TFR within T1 patients (p 5 .34) or T2/T3 patients (p 5 .44). Conclusion. Our limited analysis highlights the importance of completestagingatdiagnosisandsuggeststhatthetreatment modality does not affect the risk of recurrence in T1 indolent PCBCL.The Oncologist 2015;20:1–6