Abstract 338P
Background
Nasal type NKTCL refers to upper aerodigestive tract (UAT) involvement while non-nasal type does not involve UAT at initial diagnosis. Since NKTCLs are predominantly nasal type, there remains little knowledge of non-nasal type disease.
Methods
Newly diagnosed advanced-stage non-nasal and nasal type NKTCL patients from two large cancer centers in the past 10-15 years were retrospectively collected.
Results
The study included 56 non-nasal type NKTCL patients with 139 nasal cases as controls. The non-nasal type NKTCLs exhibited higher Ki-67 expression levels compared to nasal cases (P=0.011) with no significant differences in other baseline features. With a median follow-up of 75.03 months, the non-nasal group showed slightly inferior overall survival (OS) compared to the nasal group (median OS [mOS]: 14.57 vs. 21.53 months, P=0.120). ECOG score≥2 (hazard ratio [HR]=2.18, P=0.039) and LDH elevation (HR=2.44, P=0.012) were correlated with worse OS, and the modified nomogram-revised risk index (NRI) and international prognostic index (IPI) functioned effectively for prognostic stratification. Multi- compared to single-modality therapy led to significantly superior progression-free survival (PFS) and OS (median PFS [mPFS]: 11.53 vs. 2.03 months, P=0.001; mOS: 52.80 vs. 7.70 months, P=0.006). Chemoradiotherapy combination significantly improved survival compared to other modalities (mPFS: 14.00 vs. 3.47 months, P=0.050; mOS: 56.40 vs. 9.30 months, P=0.046), and gemcitabine- compared to non-gemcitabine-based regimens showed a trend towards slightly improved outcomes (mPFS: 10.43 vs. 3.40 months, P=0.106; mOS: 25.13 vs. 9.30 months, P=0.125). Table: 338P
Prognostic stratification of advanced-stage non-nasal type ENKTLs
Model | Variable | Risk stratification | Score | Non-nasal type (n=56) (%) | Nasal type (n=139) (%) |
Modified NRI | Age (>60 vs. ≤60 years)ECOG score (≥2 vs. 0-1) Elevated LDH (yes vs. no) | low risk | 0 | 16(28.6) | 46(33.1) |
high risk | 1 | 30(53.6) | 71(51.1) | ||
2 | 5(8.9) | 20(14.4) | |||
3 | 5(8.9) | 2(1.4) | |||
Modified PINK | Age (>60 vs. ≤60 years) Non-nasal type (yes vs. no) | / | 0 | 0 | 121(87.1) |
1 | 45(80.4) | 18(12.9) | |||
2 | 11(19.6) | 0 | |||
Modified IPI | Age (>60 vs. ≤60 years)ECOG score (≥2 vs. 0-1)Elevated LDH (yes vs. no)Extranodal involvement (≥2 vs. 0-1) | low risk | 0 | 2(3.6) | 6(4.3) |
1 | 16(28.6) | 46(33.1) | |||
high risk | 2 | 28(50.0) | 66(47.5) | ||
3 | 5(8.9) | 19(13.7) | |||
4 | 5(8.9) | 2(1.4) |
Conclusions
Advanced-stage non-nasal type NKTCL patients could achieve comparable prognosis with nasal cases after rational comprehensive therapy. Potent therapy is preferred in young patients with previously untreated disease, good performance status, and relatively low tumor burden.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Chinese Geriatric Oncology Society Scientific Research Fund (CGOS-06-2014-1-1-01600).
Disclosure
All authors have declared no conflicts of interest.
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