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Characteristics, Prognostic Factors, and Survival of Patients with NK/T-Cell Lymphoma of Non-upper Aerodigestive Tract: A 17-Year Single-Center Experience

Cancer Research and Treatment 2019년 51권 4호 p.1557 ~ 1567
 ( Liu Ze-Long ) - Sun Yat-Sen University Cancer Center Department of Medical Oncology

 ( Bi Xi-Wen ) - Sun Yat-Sen University Cancer Center Department of Medical Oncology
 ( Zhang Xue-Wen ) - Sun Yat-Sen University Cancer Center Department of Medical Oncology
 ( Lei De-Xin ) - Sun Yat-Sen University Cancer Center Department of Medical Oncology
 ( Liu Pan-Pan ) - Sun Yat-Sen University Cancer Center Department of Medical Oncology
 ( Yang Hang ) - Sun Yat-Sen University Cancer Center Department of Medical Oncology
 ( Gao Yan ) - Sun Yat-Sen University Cancer Center Department of Medical Oncology
 ( Jiang Yuan-Xue ) - Pan Yu Central Hospital Department of Oncology
 ( Jiang Wen-Qi ) - Sun Yat-Sen University Cancer Center Department of Medical Oncology

Abstract


Purpose: The extranodal natural killer (NK)/T-cell lymphoma (NKTCL) of non-upper aerodigestive tract (NUAT) was found to have clinical heterogeneity compared with NKTCL of the upper aerodigestive tract (UAT) in small scale studies. We conducted this study in a much larger cohort to analyze the clinical characteristics, prognostic factors, treatment modality, and clinical outcomes of patients with NUAT-NKTCL.

Materials and Methods: From January 2001 to December 2017, a total of 757 NKTCL patients were identified and included in this study, including 92 NUAT-NKTCL patients (12.2%) and 665 UAT-NKTCLpatients (87.8%).

Results: NUAT-NKTCL patients had relatively poorer performance status, more unfavorable prognostic factors, and more advanced stage, compared with UAT-NKTCL patients. The 5-year overall survival (OS) was 34.7% for NUAT-NKTCL, which was significantly worse than UAT-NKTCL (64.2%, p<0.001). The median OS duration was 30.9 months for NUAT-NKTCL. Multivariate analysis showed that presence with B symptoms and elevated serum lactate dehydrogenase independently predicted worse OS. International prognostic index score and prognostic index of natural killer lymphoma score still had prognostic values in NUAT-NKTCL, while the Ann Arbor system could not accurately predict the OS.

Conclusion: NUAT-NKTCL is a distinctive subtype of NKTCL in many aspects. Patients with NUAT-NKTCL have relatively poorer performance status, more unfavorable prognostic factors, more advanced stage, and poorer prognosis.

키워드

Extranodal NK-T-Cell Lymphoma; Non-upper aerodigestive tract; Prognostic factors; Survival
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