Analysis Of Prognostic Factors Of108Cases With Extranodal NK/T Cell Lymphoma

Background and objective:Extranodal NK/T cell lymphoma is a type of non Hodgkin lymphoma with unique clinical features and highly malignant, usually with poor prognosis, strong invasiveness, easy recurrence and metastasis, yet not appears general treatment protocols and the effect of clinical treatment shows individual differences.The aim of the studies of large sample of prognostic factors of extranodal NK/T lymphoma with retrospective analysis is to further clarify its prognostic factors for further treatment and prognosis.Method:From May of2006to December of2011there are108cases in total taken by The Second Xiangya Hospital of Central South University, Hunan Tumor Hospital and Hunan Provincial People’s Hospital. It is decided as NK/T cell lymphoma tumor case by pathological diagnosis, and the retrospective analysis of survival rate is conducted on these cases.(among which there are37cases in The Second Xiangya Hospital of Central South University,11cases in Hunan Tumor Hospital and60cases in Hunan Provincial People’s Hospital.). The ratio of male and female of the entire team is2.09:1(73:35). The median age is42(12-74). There are70cases of patients whose IPI is less than2, and there are38cases whose IPI is equal to or more than2. There are no patients whose IPI is4and5which belongs to high risk patients. There are59cases of B symptomatic positive patients (54.6%). Besides,52cases have seen the patients’LDH increase (48.1%). It is summarized that there are22cases of LTI positive patients (skin-bone invasion)(20.4%).57cases have seen patients’KPS exceeding and equaling to80and there are51cases of patients whose KPS is less than80. The number of Anemia patients is26(24.1%) whereas there are82cases of patients without Anemia. The number of primary inner respiratory patients is92and the number of primary outer respiratory patients is15. However, there is a patient with the unclear primary situation. All the patients in the team have gone through chest radiography, abdominal B ultrasound, the MRI of related parts or CT and the bone marrow aspiration so as to decide the scope of the tumor. In addition the phases have been divided based on the currently utilized Ann Arbor there are54cases of IE phase patients in the entire team,27cases of ⅡE phase patients and12for cases of III phase patients,15cases of IV phase patients.Among them the IE phase is defined by Chinese Academy of Medical Sciences (the restrictive IE phase refers to the tumor is restricted to the nasal cavity, the non-invaded and surrounding organs; the ultra cavity IE phase refers to the tumor has expanded beyond the nasal cavity and it has invaded the surrounding organs but it has not been integrated with lymphoma or distant metastases). There are14cases of IE phase patients in the entire team and40cases of ultra cavity IE patients. The analysis of statistics related to12factors was conducted after the patients survival prognosis.The12factors are patient age, gender, the existence of B symptom, the LDH figure, the KPS evaluation, the existence of skin-bone invasion, Ann Abor phase division, treatment mode, IPI evaluation, the existence of Anemia, the primary part of the tumor, and the existence of CR after initial treatment. Considering all kinds of factors and the relevance after prognosis the single factor survival analysis adopted Kaplan-Meier method and the multiple factor prognosis analysis adopted COX retrospective analysis. The comparison among team adopted log-rank test whereas the ratio among teams utilized X2test.Results:In the entire team the time of median survival is545days, the average survival time is595days. The survival rate of1,2,5is72.2%,37.4%、4%respectively. The survival of1,3,5years for I phase patients are80.8%、42%、21.6%respectively; the survival of1,3,5years for Ⅱ phase patients are80.3%、16.6%、16.6%respectively; the survival of1,3,5years for Ⅲ phase patients are39.1%,0%,0%respectively and the survival of1,3,5years for IV phase patients are16%,0%,0%respectively. The factors impacting the prognosis include:(1) the existence of primary respiratory of inner digestive tract,(2) Ann Abor phase division,(3) treatment modes,(4) LTI,(5) LDH,(6) the existence of anemia,(7) the existence of CR after initial treatment (8) B symptom(9) KPS evaluation. However, the gender, age,and IPI evaluation have no statistical significance for the influence on the prognosis.Conclusions:1. The analysis of single factor indicates that there are seven elements related to prognosis, they are:(1) the existence in primary respiratory inner digestive tract,(2) Ann Abor phase division,(3) treatment mode,(4) LTI,(5) LDH,(6) The existence of anemia,(7) The existence of CR after initial treatment (8) B symptom(9) KPS evaluation..2. Multiple factors include the aforementioned independent factor related to prognosis. After the initial treatment whether CR and Ann Abor phase division are related to prognosis...