TY - JOUR
T1 - Identifying unmet needs and challenges in the definition of a plaque in mycosis fungoides
T2 - An EORTC-CLTG/ISCL survey
AU - Quaglino, Pietro
AU - Scarisbrick, Julia
AU - Roccuzzo, Gabriele
AU - Abeldano, Alejandra
AU - Battistella, Maxime
AU - McCormack, Chris
AU - Cowan, Richard
AU - Cozzio, Antonio
AU - Cury-Martins, Jade
AU - Enz, Paula
AU - Geskin, Larisa
AU - Guenova, Emmanuella
AU - Kim, Youn H
AU - Knobler, Robert
AU - Litvinov, Ivan V
AU - Miyagaki, Tomomitsu
AU - Molgo, Montserrat
AU - Nicolay, Jan
AU - Papadavid, Evangelina
AU - Pinter-Brown, Lauren
AU - Pujol Vallverdu, Ramon
AU - Querfeld, Christiane
AU - Ortiz-Romero, Pablo
AU - Stadler, Rudolf
AU - Vermeer, Maarten H
AU - Bagot, Martine
AU - Hodak, Emmilia
N1 - © 2023 European Academy of Dermatology and Venereology.
PY - 2023/4
Y1 - 2023/4
N2 - BACKGROUND: Consensus about the definition and classification of 'plaque' in mycosis fungoides is lacking.OBJECTIVES: To delineate a comprehensive view on how the 'plaque' entity is defined and managed in clinical practice; to evaluate whether the current positioning of plaques in the TNMB classification is adequate.METHODS: A 12-item survey was circulated within a selected panel of 22 experts (pathologists, dermatologists, haematologists and oncologists), members of the EORTC and International Society for Cutaneous Lymphoma. The questionnaire discussed clinical and histopathological definitions of plaques and its relationship with staging and treatment.RESULTS: Total consensus and very high agreement rates were reached in 33.3% of questions, as all panellists regularly check for the presence of plaques, agree to evaluate the presence of plaques as a potential separate T class, and concur on the important distinction between plaque and patch for the management of early-stage MF. High agreement was reached in 41.7% of questions, since more than 50% of the responders use Olsen's definition of plaque, recommend the distinction between thin/thick plaques, and agree on performing a biopsy on the most infiltrated/indurated lesion. High divergence rates (25%) were reported regarding the possibility of a clinically based distinction between thin and thick plaques and the role of histopathology to plaque definition.CONCLUSIONS: The definition of 'plaque' is commonly perceived as a clinical entity and its integration with histopathological features is generally reserved to specific cases. To date, no consensus is achieved as for the exact definition of thin and thick plaques and current positioning of plaques within the TNMB system is considered clinically inadequate. Prospective studies evaluating the role of histopathological parameters and other biomarkers, as well as promising diagnostic tools, such as US/RM imaging and high-throughput blood sequencing, are much needed to fully integrate current clinical definitions with more objective parameters.
AB - BACKGROUND: Consensus about the definition and classification of 'plaque' in mycosis fungoides is lacking.OBJECTIVES: To delineate a comprehensive view on how the 'plaque' entity is defined and managed in clinical practice; to evaluate whether the current positioning of plaques in the TNMB classification is adequate.METHODS: A 12-item survey was circulated within a selected panel of 22 experts (pathologists, dermatologists, haematologists and oncologists), members of the EORTC and International Society for Cutaneous Lymphoma. The questionnaire discussed clinical and histopathological definitions of plaques and its relationship with staging and treatment.RESULTS: Total consensus and very high agreement rates were reached in 33.3% of questions, as all panellists regularly check for the presence of plaques, agree to evaluate the presence of plaques as a potential separate T class, and concur on the important distinction between plaque and patch for the management of early-stage MF. High agreement was reached in 41.7% of questions, since more than 50% of the responders use Olsen's definition of plaque, recommend the distinction between thin/thick plaques, and agree on performing a biopsy on the most infiltrated/indurated lesion. High divergence rates (25%) were reported regarding the possibility of a clinically based distinction between thin and thick plaques and the role of histopathology to plaque definition.CONCLUSIONS: The definition of 'plaque' is commonly perceived as a clinical entity and its integration with histopathological features is generally reserved to specific cases. To date, no consensus is achieved as for the exact definition of thin and thick plaques and current positioning of plaques within the TNMB system is considered clinically inadequate. Prospective studies evaluating the role of histopathological parameters and other biomarkers, as well as promising diagnostic tools, such as US/RM imaging and high-throughput blood sequencing, are much needed to fully integrate current clinical definitions with more objective parameters.
KW - Humans
KW - Prospective Studies
KW - Mycosis Fungoides/pathology
KW - Lymphoma, T-Cell, Cutaneous/pathology
KW - Skin Neoplasms/pathology
KW - Biopsy
UR - https://www.scopus.com/pages/publications/85146345349
U2 - 10.1111/jdv.18852
DO - 10.1111/jdv.18852
M3 - Article
C2 - 36606565
SN - 0926-9959
VL - 37
SP - 680
EP - 688
JO - Journal of the European Academy of Dermatology and Venereology
JF - Journal of the European Academy of Dermatology and Venereology
IS - 4
ER -
SDG 3 Good Health and Well-being