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 Blood, 1 December 2005, Vol. 106, No. 12, pp. 3785-3790.
Prepublished online as a Blood First Edition Paper on August 18, 2005; DOI 10.1182/blood-2005-05-2056.

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CLINICAL TRIALS AND OBSERVATIONS

Local tumor invasiveness is more predictive of survival than International Prognostic Index in stage IE/IIE extranodal NK/T-cell lymphoma, nasal type

Tae Min Kim, Yeon Hee Park, Sang-Yoon Lee, Ji-Hoon Kim, Dong-Wan Kim, Seock-Ah Im, Tae-You Kim, Chul Woo Kim, Dae Seog Heo, Yung-Jue Bang, Kee-Hyun Chang, and Noe Kyeong Kim

From the Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea; Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea; and Departments of Radiology and Pathology, Seoul National University College of Medicine, Seoul, Korea.

This study was launched to determine the prognostic significance of local tumor invasiveness (LTI) in 114 patients diagnosed with stage IE/IIE extranodal natural killer (NK)/T-cell lymphoma, nasal type (NTCL). LTI was defined as bony invasion or destruction or tumor invasion of the skin. Complete remission (CR), overall survival (OS), and disease-free survival (DFS) were compared between each group according to LTI, Ann Arbor stage, and International Prognostic Index (IPI). LTI was observed in 23 patients. Using multivariate analysis, factors associated with low probability of CR were the presence of LTI (P < .001), the presence of B symptoms (P = .003), and single-modality chemotherapy (P = .045). The presence of LTI (relative risk [RR] = 8.4, 95% confidence interval [CI] 3.9-17.9; P < .001) and high IPI score (RR = 2.8, 95% CI 1.2-6.8; P = .019) were also predictive of OS. The presence of LTI (RR = 7.3, 95% CI 3.2-16.5; P < .001) was an independently significant factor for reduced DFS. Ann Arbor staging system did not predict CR, OS, or DFS but IPI did have predictive power with regard to survival outcome. LTI is the most important prognostic factor in predicting low probability of CR and reduced OS and DFS in nasal stage IE/IIE NTCL.


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