Clinical impact of lymphatic spread in patients with limited-stage upper aerodigestive tract NK/T cell lymphoma

Background We investigated whether distancemax, that is, the degree of distance between the upper aerodigestive tract (UAT) mass and the farthest pathologic lymph node, was significantly associated with survival in patients with limited-stage UAT natural killer/T cell lymphoma (NKTCL). Methods A total of 157 patients who received chemotherapy (CTx) with/without radiotherapy (RTx) were enrolled. Results In the survival analysis, an elevated lactate dehydrogenase level [progression-free survival (PFS): hazard ratio (HR), 2.948; 95% confidence interval (CI), 1.606. 5.404; P<0.001; overall survival (OS): HR, 2.619; 95% CI, 1.594. 4.822; P=0.003], short distance(max) (PFS: HR, 0.170; 95% CI, 0.071. 0.410; P<0.001; OS: HR, 0.142; 95% CI, 0.050. 0.402; P < 0.001), and CTx combined with RTx (HR, 0.168; 95%CI, 0.079. 0.380; P<0.001; OS: HR, 0.193; 95% CI, 0.087. 0.429; P<0.001) had an independent predictive value for PFS and OS. Conclusion The evaluation of the degree of lymphatic spread and local control by CTx combined with RTx is essential in patients with limited-stage UAT NKTCL.

Automated summary

In patients with limited-stage UAT NK/T cell lymphoma, elevated lactate dehydrogenase level, short distancemax, and chemotherapy combined with radiotherapy have independent predictive value for progression-free survival and overall survival. Evaluating lymphatic spread and local control is essential for these patients.