Clinical characteristics, pathological distribution, and prognostic factors in non-Hodgkin lymphoma of Waldeyer’s ring: nationwide Korean study
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background/Aims: In Asia, the incidence of non-Hodgkin lymphoma (NHL) hasincreased in recent decades. Waldeyer’s ring (WR) is the most common site ofNHL involving the head and neck. In this study, the pathological distribution ofWR-NHL and its clinical features were analyzed retrospectively. Methods: From January 2000 through December 2010, we analyzed the medicalrecords of 328 patients from nine Korean institutions who were diagnosed withWR-NHL. Results: The study group comprised 197 male and 131 female patients with amedian age of 58 years (range, 14 to 89). The rate of localized disease (stage I/II)was 64.9%, and that of low-risk disease (low/low-intermediate, as defined by theInternational Prognostic Index) was 76.8%. Diffuse large B-cell lymphoma (DLBCL;240 patients, 73.2%) was the most common pathologic subtype, followed byperipheral T-cell lymphoma (14 patients, 4.3%) and nasal NK/T-cell lymphoma (14patients, 4.3%). WR-NHL occurred most frequently in the tonsils (199 patients,60.6%). Extranodal involvement was greater with the T-cell subtype (20 patients,42.5%) compared with the B-cell subtype (69 patients, 24.5%). Multivariate analysesshowed that age ≥ 62 years, T-cell subtype, and failure to achieve completeremission were significant risk factors for overall survival. Conclusions: DLBCL was found to have a higher incidence in Korea than thoseincidences reported by other WR-NHL studies. T-cell lymphoma occurred morefrequently than did follicular lymphoma. T-cell subtype, age ≥ 62 years, and completeremission failure after first-line treatment were significant poor prognosticfactors for overall survival according to the multivariate analysis.
Abstract
Background/Aims: In Asia, the incidence of non-Hodgkin lymphoma (NHL) hasincreased in recent decades. Waldeyer’s ring (WR) is the most common site ofNHL involving the head and neck. In this study, the pathological distribution ofWR-NHL and its clinical features were analyzed retrospectively. Methods: From January 2000 through December 2010, we analyzed the medicalrecords of 328 patients from nine Korean institutions who were diagnosed withWR-NHL. Results: The study group comprised 197 male and 131 female patients with amedian age of 58 years (range, 14 to 89). The rate of localized disease (stage I/II)was 64.9%, and that of low-risk disease (low/low-intermediate, as defined by theInternational Prognostic Index) was 76.8%. Diffuse large B-cell lymphoma (DLBCL;240 patients, 73.2%) was the most common pathologic subtype, followed byperipheral T-cell lymphoma (14 patients, 4.3%) and nasal NK/T-cell lymphoma (14patients, 4.3%). WR-NHL occurred most frequently in the tonsils (199 patients,60.6%). Extranodal involvement was greater with the T-cell subtype (20 patients,42.5%) compared with the B-cell subtype (69 patients, 24.5%). Multivariate analysesshowed that age ≥ 62 years, T-cell subtype, and failure to achieve completeremission were significant risk factors for overall survival. Conclusions: DLBCL was found to have a higher incidence in Korea than thoseincidences reported by other WR-NHL studies. T-cell lymphoma occurred morefrequently than did follicular lymphoma. T-cell subtype, age ≥ 62 years, and completeremission failure after first-line treatment were significant poor prognosticfactors for overall survival according to the multivariate analysis.
참고문헌 (28)
- Ferlay J, "Estimates of worldwide burden of cancer in 2008:GLOBOCAN 2008", Int J Cancer, 127, pp.2893~2917 (2010)
- Parkin DM, "Global cancer statistics, 2002", CA Cancer J Clin, 55, pp.74~108 (2005)
- Baris D, "Epidemiology of lymphomas", Curr Opin Oncol, 12, pp.383~394 (2000)
- Weisenburger DD, "Epidemiology of non-Hodgkin’s lymphoma: recent findings regarding an emerging epidemic", Ann Oncol, 5(Suppl 1), pp.19~24 (1994)
- Hoppe RT, "Non-Hodgkin’s lymphoma: involvement of Waldeyer’s ring", Can-cer, 42, pp.1096~1104 (1978)
- Yuen A, "Lymphomas of the head and neck", Semin Oncol, 26, pp.338~345 (1999)
- Yong W, "Prognostic factors and therapeutic efficacy of combined radio-chemotherapy in Waldeyer’s ring non-Hodgkin lymphoma", Chin Med J (Engl), 113, pp.148~150 (2000)
- Jacobs C, "The management of extranodal head and neck lymphomas", Arch Otolaryngol Head Neck Surg, 112, pp.654~658 (1986)
- Ko YH, "Malignant lymphomas of the nasal cavity and Waldeyer’s ring:clinicopathologic and immunohistochemical study", J Korean Med Sci, 7, pp.314~324 (1992)
- Yamanaka N, "Non-Hodgkin’s lymphoma of Waldeyer’s ring and nasal cavity:clinical and immunologic aspects", Cancer, 56, pp.768~776 (1985)
- Swerdlow SH, "WHO Classif ication: Pathology and Genetics of Tumors of Haematopoietic and Lymphoid Tissues" (2008), International Agency for Research on Cancer
- Jaffe ES, "WHO Classification:Pathology and Genetics of Tumors of Haematopoietic and Lymphoid Tissues" (2001), International Agency for Research on Cancer
- Wang SS, "Immune mechanisms in non-Hodgkin lymphoma: joint effects of the TNF G308A and IL10 T3575A polymorphisms with non-Hodgkin lymphoma risk factors", Cancer Res, 67, pp.5042~5054 (2007)
- 류민희, "REAL 분류상 B-미만성 대세포 림프종에서 조직학적 아형 분류의 임상적 의의", 대한내과학회지, 65(1), pp.71~80 (2003), 대한내과학회
- Krol AD, "Waldeyer’s ring lymphomas: a clinical study from the Comprehensive Cancer Center West population based NHL registry", Leuk Lymphoma, 42, pp.1005~1013 (2001)
- Kwong YL, "Management of T-cell and natural-killer-cell neoplasms in Asia:consensus statement from the Asian Oncology Summit 2009", Lancet Oncol, 10, pp.1093~1101 (2009)
- Harabuchi Y, "Prognostic factors and treatment outcome in non-Hodgkin’s lymphoma of Waldeyer’s ring", Acta Oncol, 36, pp.413~420 (1997)
- Chadburn A, "KSHV-positive solid lymphomas represent an extra-cavitary variant of primary effusion lymphoma", Am J Surg Pathol, 28, pp.1401~1416 (2004)
- Matsuoka M, "Human T-cell leukemia virus type I and adult T-cell leukemia", Oncogene, 22, pp.5131~5140 (2003)
- Engels EA, "Immune-related conditions and immune-modulating medications as risk factors for non-Hodgkin’s lymphoma: a case-control study", Am J Epidemiol, 162, pp.1153~1161 (2005)
- "A predictive model for aggressive non-Hodgkin’s lymphoma. The International Non-Hodgkin’s Lymphoma Prognostic Factors Project", N Engl J Med, 329, pp.987~994 (1993)
- Lopez-Guillermo A, "Diffuse large B-cell lymphoma: clinical and biological characterization and outcome according to the nodal or extranodal primary origin", J Clin Oncol, 23, pp.2797~2804 (2005)
- Ezzat AA, "Localized non-Hodgkin’s lymphoma of Waldeyer’s ring: clinical features, management, and prognosis of 130 adult patients", Head Neck, 23, pp.547~558 (2001)
- Rosenwald A, "The use of molecular profiling to predict survival after chemotherapy for diffuse large-B-cell lymphoma", N Engl J Med, 346, pp.1937~1947 (2002)
- Alizadeh AA, "Distinct types of diffuse large B-cell lymphoma identified by gene expression profiling", Nature, 403, pp.503~511 (2000)
- de Leval L, "Diffuse large B-cell lymphoma of Waldeyer’s ring has distinct clinicopathologic features: a GELA study", Ann Oncol, 23, pp.3143~3151 (2012)
- Hans CP, "Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray", Blood, 103, pp.275~282 (2004)
- Mohammadianpanah M, "Treatment results of tonsillar lymphoma: a 10-year experience", Ann Hematol, 84, pp.223~226 (2005)