Tumor necrosis and complete resection has significant impacts on survival in patients with limited-stage upper aerodigestive tract NK/T cell lymphoma

// Moo-Kon Song 1 , Joo-Seop Chung 2 , Ho-Young Yhim 3 , Sung-Nam Lim 4 , Seong-Jang Kim 5 , Yeon-Hee Han 6 , Hye-Kyung Shim 7 , Sung-Hoon Jung 8 , Je-Jung Lee 8 and Deok-Hwan Yang 8 1 Department of Hemato-Oncology, Hanyang University Hanmaeum Changwon Hospital, Changwon, Korea 2 Department of Hematology-Oncology, Pusan National University Hospital, Busan, Korea 3 Department of Hematology, Chonbuk National University Hospital, Jeonju, Korea 4 Department of Hematology, Busan Haeundae Paik Hospital, Busan, Korea 5 Department of Nuclear Medicine, Pusan National University Hospital, Busan, Korea 6 Department of Nuclear Medicine, Chonbuk National University Hospital, Jeonju, Korea 7 Department of Nuclear Medicine, Busan Haeundae Paik Hospital, Busan, Korea 8 Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Korea Correspondence to: Deok-Hwan Yang, email: // Keywords : extranodal natural killer/T-cell lymphoma, tumor necrosis, complete resection, prognosis Received : March 31, 2017 Accepted : May 10, 2017 Published : May 23, 2017 Abstract Tumor necrosis (TN) is associated with worse prognosis in several solid cancers. Whether TN predicts poor outcome in natural killer cell / T cell lymphoma (NKTCL) is unclear. We investigated the clinical impact of TN on survival and other novel prognostic parameters in upper aero-digestive tract (UAT) NKTCL of 100 patients with limited stage. TN was significantly associated with poor performance status ( p = 0.049), high Korean Prognostic Index score ( p = 0.024), high C-reactive protein/albumin ratio ( p = 0.003), higher maximum standard uptake value on positron emission tomography/computed tomography (PET/CT) ( p = 0.008) and higher metabolic tumor volume (MTV) on PET/CT ( p < 0.001). In univariate and multivariate analyses, progression-free survival and overall survival were independently associated with High MTV status ( p = 0.001, p = 0.032), TN ( p = 0.018, p = 0.009), local tumor invasiveness ( p = 0.007, p = 0.035), complete resection ( p = 0.020, p = 0.028) and regional lymph node involvement ( p < 0.001, p < 0.001). TN and complete resection are concluded to be novel independent prognostic factors in patients with UAT NKTCL.