Prognostic role of primary tumor burden in extranodal nasal-type NK/T-cell lymphoma
10.3760/cma.j.issn.1004-4221.2017.05.011
- VernacularTitle:原发肿瘤负荷对结外鼻型NK/T细胞淋巴瘤预后影响
- Author:
Shunan QI
;
Liming XU
;
Zhiyong YUAN
;
Jianzhong CAO
;
Shengmin LAN
;
Junxin WU
;
Tao WU
;
Suyu ZHU
;
Liting QIAN
;
Xiaorong HOU
;
Fuquan ZHANG
;
Yujing ZHANG
;
Yuan ZHU
;
Yong YANG
;
Yexiong LI
- Keywords:
NK/T-cell lymphoma;
Prognosis;
Tumor burden
- From:
Chinese Journal of Radiation Oncology
2017;26(5):532-537
- CountryChina
- Language:Chinese
-
Abstract:
Objective There is still a lack of effective clinical prognostic factors for predicting outcomes and guiding treatments in extranodal nasal-type NK/T-cell lymphoma (NKTCL).This study was aimed to investigate the clinical features and prognostic role of primary tumor burden (PTB).Methods A total of 1383 patients were recruited from ten hospitals, including 947 stage Ⅰ patients (68.5%), 326 stage Ⅱ patients (23.6%), and 110 stage Ⅲ-IV patients (8.0%).There were 751 patients (54.3%) presenting with high PTB (H-PTB).The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was conducted for survival difference analysis.Meanwhile, a multivariate analysis was performed using the Cox regression model.Results H-PTB was associated with high invasive potential, high frequency of B symptoms, advanced stage, regional lymph node involvement, lactate dehydrogenase elevation, and poor performance status.The patients with H-PTB had significantly lower 5-year overall survival (OS) and progression-free survival (PFS) rates than those with low PTB (L-PTB)(OS:50.2% vs.72.1%, P=0.000;PFS:41.8% vs.62.5, P=0.000).PTB was an independent prognostic factor for both OS (HR=1.851) and PFS (HR=1.755) according to the Cox multivariate analysis.Moreover, H-PTB was associated with significantly lower locoregional control (LRC) in early-stage NKTCL, and the 5-year LRC rate was 71.6% in patients with H-PTB and 84.3% in those with L-PTB (P=0.000).Conclusions H-PTB is associated with multiple adverse clinical features in NKTCL, and it is an independent indicator for poor outcomes and LRC.H-PTB can be used as a reliable indicator for risk stratification and treatment decision.
