Primary site and regional lymph nodeinvolvement are independent prognosticfactors for early？stage extranodal nasal？typenatural killer/T cell lymphoma

作     者：Shao‑Qing Niu Yong Yang Yi‑Yang Li Ge Wen Liang Wang Zhi‑Ming Li Han‑Yu Wang Lu‑Lu Zhang Yun‑Fei Xia Yu‑Jing Zhang 

作者机构：State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineSun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China Department of Radiation OncologySun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China Department of Radiation OncologyThe First Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510060GuangdongP.R.China Department of Radiation OncologyCancer Hospital and InstitutePeking Union Medical College(PUMC)and Chinese Academy of Medical Sciences(CAMS)Beijing 100021P.R.China Department of Nuclear MedicineThe Third Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510150GuangdongP.R.China Department of Hematological OncologySun Yatsen University Cancer CenterGuangzhou 510060GuangdongP.R.China Department of Medical OncologySun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China 

出 版 物：《Chinese Journal of Cancer》 (Chinese Journal of Cancer)

年 卷 期：2016年第35卷第5期

页      面：255-263页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：pathologists at Sun Yat-sen University Cancer Center 

主　　题：Extranodal natural killer/T-cell lymphoma (ENKTCL), Nasal cavity, Lymph node, Prognosis, Nomogram 

摘      要：Background:Nasal-type extranodal natural killer/T-cell lymphoma(ENKTCL) originates primarily in the nasal cavity or extra-nasal sites within the upper aerodigestive tract.However,it is unclear whether the primary site can serve as an independent prognostic factor or whether the varying clinical outcomes observed with different primary sites can be attributed merely to their propensities of regional lymph node involvement.The aim of this study was to investigate the prognostic implications of the primary site and regional lymph node involvement in patients with early-stage nasal-type ENKTCL.Methods:To develop a nomogram,we reviewed the clinical data of 215 consecutively diagnosed patients with early-stage nasal-type ENKTCL who were treated in Sun Yat-sen University Cancer Center with chemotherapy and radiotherapy between 2000 and 2011.The predictive accuracy and discriminative ability of the nomogram were determined using a concordance index(C-index) and calibration curve.Results:The 5-year overall survival(OS) and progression-free survival(PFS) rates of patients with nasal ENKTCL were higher than those of patients with extra-nasal ENKTCL(OS:68.2%vs.46.0%,P = 0.030;PFS:53.4%vs.26.6%,P = 0.010).The 5-year OS and PFS rates of patients with Ann Arbor stage IE ENKTCL were higher than those of patients with Ann Arbor stage HE ENKTCL(OS:66.3%vs.59.2%,P = 0.003;PFS:51.4%vs.40.3%,P = 0.009).Multivariate analysis showed that age 60 years,ECOG performance status score 2,elevated lactate dehydrogenase(LDH) level,extranasal primary site,and regional lymph node involvement were significantly associated with lower 5-year OS rate;age 60 years,elevated LDH level,extra-nasal primary site,and regional lymph node involvement were significantly associated with lower 5-year PFS rate.The nomogram included the primary site and regional lymph node involvement based on multivariate analysis.The calibration curve showed good agreement between the predicted and actual 5-year OS and PFS rates,and the C-indexes of the nomogram for the OS and PFS rates were 0.697 and 0.634,respectively.Conclusions:The primary site and regional lymph node involvement are independent prognostic factors for earlystage ENKTCL treated with chemotherapy followed by definitive radiotherapy.