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A TNM Staging System for Nasal NK/T-Cell Lymphoma.

Yan Z, Huang HQ, Wang XX, Gao Y, Zhang YJ, Bai B, Zhao W, Jiang WQ, Li ZM, Xia ZJ, Lin SX, Xie CM - PLoS ONE (2015)

Bottom Line: This staging system showed excellent performance in prognosticating survival.Moreover, the predictive value of several currently used factors was abrogated in the presence of the TNM stage.The TNM staging system is highly effective in stratifying tumor burden and survival risk, which may have significant implications in the treatment decision making for patients with N-NKTCL.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China; Stage Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.

ABSTRACT
Ann Arbor stage has limited utility in the prognostication and treatment decision making in patients with NK/T-cell lymphoma (NKTCL), as NKTCL is almost exclusively extranodal and the majority is localized at presentation for which radiotherapy is the most important treatment and local invasiveness is the most important prognostic factor. In this study, we attempted to establish a TNM (Tumor-Node-Metastasis) staging system for nasal NKTCL (N-NKTCL). The staging rules of other head and neck cancers were used as reference along with the data of our 271 eligible patients. The primary tumor was classified into T1 to T4, and cervical lymph node metastasis was classified into N0 to N2 according to the extent of involvement. Any lesions outside the head and neck were classified as M1. N-NKTCL thereby was classified into four stages: stage I comprised T1-2N0M0; stage II comprised T1-2N1M0 and T3N0M0; stage III comprised T3N1M0, T1-3N2M0, and T4N0-2M0; and stage IV comprised TanyNanyM1. This staging system showed excellent performance in prognosticating survival. In the current series, the 5-year survival rates of patients with stages I, II, III, and IV N-NKTCL were 92%, 64%, 23%, and 0, respectively. Moreover, the predictive value of several currently used factors was abrogated in the presence of the TNM stage. The TNM staging system is highly effective in stratifying tumor burden and survival risk, which may have significant implications in the treatment decision making for patients with N-NKTCL.

No MeSH data available.


Related in: MedlinePlus

PFS curves of the entire cohort stratified by the TNM staging system.
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pone.0130984.g006: PFS curves of the entire cohort stratified by the TNM staging system.

Mentions: Finally, 88 (32.5%), 61 (22.5%), 35 (12.9%), 46 (17%), and 41 (15.1%) patients were classified into stages IA, IB, II, III, and IV, respectively. The OS curves of the entire cohort stratified by the proposed TNM stage were demonstrated. As shown in Fig 4, the new staging system performed excellently in prognostication, and it was much better than AA system (Fig 5). We tried various combinations of the T and N classifications, but none of these showed better results. The TNM staging system also worked very well when it was applied on PFS (Fig 6). According to the new staging system, the 5-year OS rates were 92%, 64%, 23%, and 0 for patients with stages I, II, III, and IV disease, respectively, and the corresponding 5-year PFS rates were 79%, 45%, 23%, and 0, respectively. The prognosis of stage IB disease was slightly poorer when compared with stage IA disease (Table 7). According to the AA stage, the 5-year OS rates were 84%, 24%, 0, and 0, and the 5-year PFS rates were 70%, 22%, 0, and 0, in patients with stages I, II, III, and IV disease, respectively.


A TNM Staging System for Nasal NK/T-Cell Lymphoma.

Yan Z, Huang HQ, Wang XX, Gao Y, Zhang YJ, Bai B, Zhao W, Jiang WQ, Li ZM, Xia ZJ, Lin SX, Xie CM - PLoS ONE (2015)

PFS curves of the entire cohort stratified by the TNM staging system.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4476596&req=5

pone.0130984.g006: PFS curves of the entire cohort stratified by the TNM staging system.
Mentions: Finally, 88 (32.5%), 61 (22.5%), 35 (12.9%), 46 (17%), and 41 (15.1%) patients were classified into stages IA, IB, II, III, and IV, respectively. The OS curves of the entire cohort stratified by the proposed TNM stage were demonstrated. As shown in Fig 4, the new staging system performed excellently in prognostication, and it was much better than AA system (Fig 5). We tried various combinations of the T and N classifications, but none of these showed better results. The TNM staging system also worked very well when it was applied on PFS (Fig 6). According to the new staging system, the 5-year OS rates were 92%, 64%, 23%, and 0 for patients with stages I, II, III, and IV disease, respectively, and the corresponding 5-year PFS rates were 79%, 45%, 23%, and 0, respectively. The prognosis of stage IB disease was slightly poorer when compared with stage IA disease (Table 7). According to the AA stage, the 5-year OS rates were 84%, 24%, 0, and 0, and the 5-year PFS rates were 70%, 22%, 0, and 0, in patients with stages I, II, III, and IV disease, respectively.

Bottom Line: This staging system showed excellent performance in prognosticating survival.Moreover, the predictive value of several currently used factors was abrogated in the presence of the TNM stage.The TNM staging system is highly effective in stratifying tumor burden and survival risk, which may have significant implications in the treatment decision making for patients with N-NKTCL.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China; Stage Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.

ABSTRACT
Ann Arbor stage has limited utility in the prognostication and treatment decision making in patients with NK/T-cell lymphoma (NKTCL), as NKTCL is almost exclusively extranodal and the majority is localized at presentation for which radiotherapy is the most important treatment and local invasiveness is the most important prognostic factor. In this study, we attempted to establish a TNM (Tumor-Node-Metastasis) staging system for nasal NKTCL (N-NKTCL). The staging rules of other head and neck cancers were used as reference along with the data of our 271 eligible patients. The primary tumor was classified into T1 to T4, and cervical lymph node metastasis was classified into N0 to N2 according to the extent of involvement. Any lesions outside the head and neck were classified as M1. N-NKTCL thereby was classified into four stages: stage I comprised T1-2N0M0; stage II comprised T1-2N1M0 and T3N0M0; stage III comprised T3N1M0, T1-3N2M0, and T4N0-2M0; and stage IV comprised TanyNanyM1. This staging system showed excellent performance in prognosticating survival. In the current series, the 5-year survival rates of patients with stages I, II, III, and IV N-NKTCL were 92%, 64%, 23%, and 0, respectively. Moreover, the predictive value of several currently used factors was abrogated in the presence of the TNM stage. The TNM staging system is highly effective in stratifying tumor burden and survival risk, which may have significant implications in the treatment decision making for patients with N-NKTCL.

No MeSH data available.


Related in: MedlinePlus