Pattern and Prognosis of Distant Metastases in Patients with Early-Stage Extranodal Nasal-Type NK/T-Cell Lymphoma

Purpose/Objective(s)

This study investigated the failure pattern and prognosis of distant metastasis for early-stage extranodal nasal-type natural killer/T-cell lymphoma (ENKTCL).

Materials/Methods

1619 patients with complete information on distant metastatic sites were identified. The distribution of distant metastatic sites was reported. The distant metastatic sites were categorized into 4 groups. The overall survival (OS) and subsequent OS of the 4 groups were compared. The effect of distant metastatic number and time on subsequent OS were evaluated.

Results

DM was the primary mode of failure in this cohort, with a 5-year cumulative of 26.2%. The most frequent distant metastatic site was skin and soft tissue (SST, 32.4%), followed by distant lymph node (LN, 31.1%), lung (17.3%), liver (14.6%), lymphoma-associated hemophagocytic lymphohistiocytosis (LAHS, 10.7%) and gastrointestinal system (10.4%). While central nervous system, spleen, urogenital system, adrenal glands, bone, bone marrow and pancreas involvements were less common. The distant metastatic sites were categorized in to 4 groups: distant LN, SST, other sites and LAHS. The 4 categories demonstrated distinct OS and subsequent OS, with decreased mortality for distant LN and SST compared with other sites and LAHS. Besides, solitary DM and late DM (> 7.5 months) were associated with favorable 3-year OS compared with multiple metastases (45.7% versus 8.7%, P < 0.001) and early DM (≤ 7.5 months; 25.8% versus 15.8%, P = 0.001).

Conclusion

The findings were helpful understanding the variation in biology of different sites of metastases in patients with early-stage ENKTCL and provided important information for future therapeutic decisions, metastatic surveillance and translational studies.