Anaplastic Large Cell Lymphoma: Emerging Beliefs and Management Patterns among Board Certified Plastic Surgeons
Kenneth L. Fan, MD1, Megan A. Rudolph, BA2, Troy Pittman, MD1.
1MedStar Georgetown University Hospital, Washington, DC, USA, 2George Washington University School of Medicine, Washington, DC, USA.
Our study seeks to examine plastic surgeon practice patterns in relation to ALCL, given its increasing discourse in the literature.
A 19-question survey was sent electronically US and International Board-Certified Plastic Surgeons. Data was analyzed using Chi-Squared test.
1383 surgeons(US: 702, International: 681) responded, at a rate of 13.5%. Of the 62.1% of surgeons that aspirate late seroma fluid, 27.8% don’t send for cytology. Only 36.6% physicians include ALCL risk in informed consent with 25.7% counseling on the topic. Physicians were twice as likely to consent with personal(P<0.05,OR=1.930) or colleague(P<0.05,OR=1.952) experience with ALCL. Plastic surgeons from Australia and UK(P<0.05, OR=1.916) are twice as likely to consent about ALCL compared to US counterparts. Physicians who aspirate and send for cytology were over twice as likely to include ALCL in consent(P< 0.05, OR=2.628). Those using textured implants are more likely to counsel on ALCL risk(P<0.05,OR=1.318). 10% respondents had ALCL cases, equating to 193 cases.
28% of surgeons are not sending fluid from a late seroma for cytology, deviating from FDA guidelines. Personal or colleague experience and use of textured implants makes one twice as likely to include ALCL in the consent and preoperative consultation, respectively. Those who are more informed of diagnostic workup are more likely to consent their patients about ALCL. ALCL cases are likely being underreported.
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