Characteristics, Prognostic Factors, and Survival of Patients with NK/T-Cell Lymphoma of Non-upper Aerodigestive Tract: A 17-Year Single-Center Experience
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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-NKTCL patients (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 NK 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.
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-NKTCL patients (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 NK 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.
참고문헌 (30)
- Swerdlow SH, "The 2016 revision of the World Health Organization classification of lymphoid neoplasms", Blood, 127, pp.2375~2390 (2016)
- Au WY, "Clinical differences between nasal and extranasal natural killer", T-cell lymphoma : a study of 136cases from the International Peripheral T-Cell Lymphoma Project, 2009, pp.113, 3931~3937
- Kim TM, "Clinical heterogeneity of extranodal NK", T-cell lymphoma, nasal type : a national survey of the Korean Cancer Study Group, 2008, pp.19, 1477~1484
- Lim ST, "Comparative analysis of extra-nodal NK", T-cell lymphoma and peripheral T-cell lymphoma : significant differences in clinical characteristics and prognosis, 2008, pp.80, 55~60
- Suzuki R, "Prognostic factors for mature natural killer(NK)cell neoplasms : aggressive NK cell leukemia and extranodal NK cell lymphoma, nasal type", Ann Oncol, 21, pp.1032~1040 (2010)
- Pongpruttipan T, "Extranodal NK", T-cell lymphoma, nasal type, includes cases of natural killer cell and alphabeta, gammadelta, and alphabeta, Am J Surg Pathol, pp.2012, 36[DOI]
- Jo JC, "Clinical features and prognostic model for extranasal NK", T-cell lymphoma, 2012, pp.89, 103~110
- Li S, "Extranodal NK", T-cell lymphoma, nasal type : a report of 73 cases at MD Anderson Cancer Center, 2013, pp.37, 14~23
- Bai B, "Predictive value of pretreatment positron emission tomography", computed tomography in patients with newly diagnosed extranodal natural killer, Med Oncol, pp.2013, 30[DOI]
- Lee J, "Extranodal nasal type NK", T-cell lymphoma : elucidating clinical prognostic factors for risk-based stratification of therapy, 2005, pp.41, 1402~1408
- Kim GE, "Combined chemotherapy and radiation versus radiation alone in the management of localized angiocentric lymphoma of the head and neck", Radiother Oncol, 61, pp.261~269 (2001)
- Kim BS, "Therapeutic outcome of extranodal NK", T-cell lymphoma initially treated with chemotherapy : result of chemotherapy in NK, Acta Oncol, pp.2003, 42[DOI]
- Kim WS, "CHOP followed by involved field radiation: is it optimal for localized nasal natural killer", T-cell lymphoma?, 2001, pp.12, 349~352
- Cheson BD, "Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma : the Lugano classification", J Clin Oncol, 32, pp.3059~3068 (2014)
- Tse E, "How I treat NK", T-cell lymphomas, 2013, pp.121, 4997~5005
- Lee J, "Extranodal natural killer T-cell lymphoma, nasal-type : a prognostic model from a retrospective multicenter study", J Clin Oncol, 24, pp.612~618 (2006)
- Ren YL, "Analysis of 142 Northern Chinese patients with peripheral T", NK-Cell lymphomas : subtype distribution, clinicopathologic features, and prognosis, 2012, pp.138, 435~447
- Huang JJ, "A novel prognostic model for extranodal natural killer", T-cell lymphoma, 2012, pp.29, 2183~2190
- Cai Q, "Fasting blood glucose is a novel prognostic indicator for extranodal natural killer", T-cell lymphoma, nasal type, 2013, pp.108, 380~386
- Vose J, "International peripheral T-cell and natural killer", T-cell lymphoma study: pathology findings and clinical outcomes, 2008, pp.26, 4124~4130
- Kim SJ, "A prognostic index for natural killer cell lymphoma after non-anthracycline-based treatment : a multicentre, retrospective analysis", Lancet Oncol, 17, pp.389~400 (2016)
- Chauchet A, "Complete remission after first-line radiochemotherapy as predictor of survival in extranodal NK", T cell lymphoma, 2012, pp.5, 27~
- Chim CS, "Primary nasal natural killer cell lymphoma : long-term treatment outcome and relationship with the International Prognostic Index", Blood, 103, pp.216~221 (2004)
- Li YX, "Radiotherapy as primary treatment for stage IE and IIE nasal natural killer", T-cell lymphoma, 2006, pp.24, 181~189
- Wang H, "Mild toxicity and favorable prognosis of high-dose and extended involved-field intensity-modulated radiotherapy for patients with early-stage nasal NK", T-cell lymphoma, 2012, pp.82, 1115~1121
- Wang ZY, "Primary radiotherapy showed favorable outcome in treating extranodal nasal-type NK", T-cell lymphoma in children and adolescents, 2009, pp.114, 4771~4776
- Kim GE, "Angiocentric lymphoma of the head and neck : patterns of systemic failure after radiation treatment", J Clin Oncol, 18, pp.54~63 (2000)
- Kim K, "Treatment outcome of angiocentric T-cell and NK", T-cell lymphoma, nasal type : radiotherapy versus chemoradiotherapy, 2005, pp.35, 1~5
- Lee J, "Autologous hematopoietic stem cell transplantation in extranodal natural killer", T cell lymphoma : a multinational, multicenter, matched controlled study, 2008, pp.14, 1356~1364
- Ai WZ, "Racial patterns of extranodal natural killer", T-cell lymphoma, nasal type, in California : a population-based study, 2012, pp.156, 626~632