Clinicoprognostic implications of head and neck involvement by mycosis fungoides: A retrospective cohort study - 15/04/21

Doi : 10.1016/j.jaad.2021.03.056

Joon Min Jung, MD ^a, Hanju Yoo, MS ^b, Dong Jun Lim, MD ^a, Chong Hyun Won, MD, PhD ^a, Sung Eun Chang, MD, PhD ^a, Mi Woo Lee, MD, PhD ^a, Woo Jin Lee, MD, PhD ^a,^⁎
^a Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
^b Bio-Medical Institute of Technology, University of Ulsan, College of Medicine, Ulsan, Korea

^∗Correspondence and reprint requests to: Woo Jin Lee, MD, PhD, Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.Department of DermatologyAsan Medical CenterUniversity of Ulsan College of Medicine88, Olympic-ro 43-gil, Songpa-guSeoul05505South Korea

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Abstract

Background

The clinicoprognostic implications of head and neck involvement of mycosis fungoides (MF) are poorly understood.

Objectives

To evaluate the association of head and neck involvement on the clinicoprognostic features of MF.

Methods

The clinical features and survival outcomes of patients with MF in a Korean academic medical center database were retrospectively evaluated according to the presence of head and neck involvement at diagnosis.

Findings

Cases of MF with (group A, n = 39) and without (group B, n = 85) head and neck involvement at diagnosis were identified. Advanced-stage disease (stages IIB-IVB) was more common in group A (43.6%) than in group B (5.9%) (P < .001). MF progression, extracutaneous dissemination, and large-cell transformation more commonly occurred in group A than in group B. The 10-year overall survival rate was worse in group A (53.4%) compared with group B (81.6%) (P < .001). Head and neck involvement at diagnosis was associated with poor prognosis in early-stage MF (stages IA-IIA) and was independently associated with worse progression-free survival (hazard ratio, 24.4; 95% confidence interval, 2.2-267.6; P = .009).

Limitations

A single center, retrospective design.

Conclusion

Head and neck involvement of MF was associated with a poor prognosis.

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Key words : cutaneous T-cell lymphoma, disease progression, head and neck, mycosis fungoides, prognosis, skin

Abbreviations used : CI, LDH, LN, MF, OS, PFS, TCR

Plan

Introduction

Methods

Patients

Clinical variables of interest

Survival outcome analysis

Subgroup analysis

Statistical analysis

Results

Clinical features at diagnosis

Treatment and clinical course

Survival outcomes

Stage-matched survival outcomes

Subgroup analysis after excluding folliculotropic MF

Discussion

	Authors Jung and Yoo are cofirst authors.
	Funding sources: Supported by a grant, the “Elimination of Cancer Project Fund,” from the Asan Cancer Institute of Asan Medical Center, Seoul, Korea.
	IRB approval status: This study was approved by the institutional review board of Asan Medical Center.