Abstract
Objectives: The role of body mass index (BMI) in lymphoma survival outcomes is controversial. The prognostic significance of BMI in extranodal natural killer (NK)/T-cell lymphoma (ENKTL) is unclear. We evaluated the prognostic role of BMI in patients with ENKTL.Methods: We retrospectively analyzed 742 patients with newly diagnosed ENKTL. The prognostic value of BMI was compared between patients with low BMIs (< 20.0 kg/m2) and patients with high BMIs (≥ 20.0 kg/m2). The prognostic value of the International Prognostic Index (IPI) and the Korean Prognostic Index (KPI) was also evaluated and compared with that of the BMI classification.Results: Patients with low BMIs tended to exhibit higher Eastern Cooperative Oncology Group performance status (ECOG PS) scores (≥ 2) (P = 0.001), more frequent B symptoms (P < 0.001), lower albumin levels (P < 0.001), higher KPI scores (P = 0.03), and lower rates of complete remission (P < 0.001) than patients with high BMIs, as well as inferior progression-free survival (PFS, P = 0.003), and inferior overall survival (OS, P = 0.001). Multivariate analysis demonstrated that age > 60 years, mass > 5 cm, stage III/IV, elevated LDH levels, albumin levels < 35 g/L and low BMIs were independent adverse predictors of OS. The BMI classification was found to be superior to the IPI with respect to predicting patient outcomes among low-risk patients and the KPI with respect to distinguishing between intermediate-low- and high-intermediate-risk patients.Conclusions: Higher BMI at the time of diagnosis is associated with improved overall survival in ENKTL. Using the BMI classification may improve the IPI and KPI prognostic models.
Highlights
Despite the pathogenic role of obesity in the development of cancer, the impact of body mass index (BMI) on survival is controversial
Table2: Primary treatment and response stratified by BMI
We found that increased BMI was significantly associated with improved survival outcomes among patients with extranodal natural killer (NK)/Tcell lymphoma (ENKTL)
Summary
Despite the pathogenic role of obesity in the development of cancer, the impact of body mass index (BMI) on survival is controversial. In breast cancer and colon cancer, increased BMI were reportedly associated with an increased risk of disease recurrence and death [1, 2]. Increased BMI were associated with improved survival in patients with lung cancer, gastric cancer and nasopharyngeal carcinoma [3,4,5]. Previous studies evaluating the impact of BMI on survival in lymphoma have yielded controversial results. Underweight Normal Overweight Obese (≥ P (< 18.5). (18.5–24.9) (25–29.9) 30) Low BMI (< 20) High BMI (≥ 20) P Age (years)
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