Abstract
Background:In localized extranodal natural killer/T cell lymphoma (ENKTCL), traditional prognostic models had a limited prognostic value to predict survivals. Especially, clinical data is limited to find out what the most meaningful inflammatory marker among them is and determine whether the meaningful inflammatory marker would be useful to reinforce prognostic limitations of the traditional prognostic models in ENKTCLAims:The present study was performed to find out the most meaningful factor among available inflammatory markers and to evaluate whether the inflammatory marker would improve predictive ability of traditional models in patients with limited stage UAT ENKTCL.Methods:We evaluated prognostic value of inflammatory makers in 157 patients with limited stage upper aerodigestive tract (UAT) ENKTCL. Diagnosis of ENKTCL was according to the presence of histologic findings and immunophenotypes such as CD3+, CD20‐, CD56+ and positive Epstein‐barr virus by fluorescence in situ hybridization.Statistical Analysis Chi‐square test or Fisher's exact test were used as appropriate to analyze categorical variables. Progression‐free survival (PFS) and overall survival (OS) were estimated using the Kaplan‐Meier method and the 2‐tailed log‐rank test. PFS was defined as the time between the beginning of salvage therapy until disease progression or death. Meanwhile, OS was defined as the time from the start of salvage therapy until death. Cox proportional hazard model was used to evaluate prognostic impacts of several prognostic factors. Hazard ratios (HRs) of prognostic factors were used to measure the differential risks of progression and death. Receiver operating characteristic (ROC) curves were prepared to estimate the accuracy of predicting the ideal cut‐off values of continuous variables. The statistical analysis was carried out with SPSS software version 18.0 (SPSS Inc., Chicago, IL, USA). A p‐value < 0.05 was considered significant.Results:Among several inflammatory markers, mean platelet volume (MPV) was most meaningful predictive value for progression‐free survival (PFS) and overall survival (OS). Ideal cut‐off value of MPV was 8.8 in Receiver operating characteristic analysis. In univariate and multivariate analysis, only two factors such as low MPV (< 8.8) (PFS, HR = 2.483, 95% CI = 1.182‐4.601, p = 0.009; OS, HR = 3.412, 95% CI = 1.949‐6.990, p = 0.008) and high international prognostic index (IPI) score (IPI ≥ 2) (PFS, HR = 3.339, 95% CI = 1.323‐8.430, p = 0.011; OS, HR = 3.317, 95% CI = 1.046‐6.892, p = 0.010) were significantly associated with both PFS and OS. interestingly, the MPV value could significantly subdivide low IPI score group (PFS, p = 0.006; OS, p = 0.021).Summary/Conclusion:We found that Low MPV and high IPI can significantly predict poor prognosis in localized ENKTCL.image
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