晚期非鼻型结外自然杀伤/T 细胞淋巴瘤的临床特征、预后分层及治疗：一项多机构真实世界研究

The present study aimed to investigate the clinical features, prognosis, and treatment of advanced-stage non-nasal type extranodal natural killer/T-cell lymphoma (ENKTCL). This real-world study retrospectively reviewed 56 newly diagnosed advanced-stage non-nasal type ENKTCL patients from two large-scale Chinese cancer centers in the last 10-15 years and screened 139 newly diagnosed advanced-stage nasal type ENKTCLs admitted during the same period for comparison. The non-nasal type ENKTCLs exhibited significantly higher Ki-67 expression levels compared to nasal type disease (P = 0. 011). With a median follow-up duration of 75. 03 months, the non-nasal group showed slightly inferior survival outcomes without statistically significant differences compared to the nasal group (median overall survival (OS): 14. 57 vs. 21. 53 months, 5-year OS: 28. 0% vs. 38. 5%, P = 0. 120). Eastern Cooperative Oncology Group (ECOG) score ≥ 2 (hazard ratio (HR) = 2. 18, P = 0.

039) and lactic dehydrogenase (LDH) elevation (HR = 2. 44, P = 0. 012) were significantly correlated with worse OS in the non-nasal group. First-line gemcitabine-based chemotherapy regimens showed a trend toward slightly improved efficacy and survival outcomes compared to non-gemcitabine-based ones in the present cohort of non-nasal ENKTCLs (objective response rate: 91. 7% vs. 63. 6%, P = 0. 144; complete response rate: 50. 0% vs. 33. 3%, P = 0. 502; median progression-free survival: 10. 43 vs. 3.

40 months, P = 0. 106; median OS: 25. 13 vs. 9. 30 months, P = 0. 125), which requires further validation in larger sample size studies. Advanced-stage non-nasal type patients could achieve comparable prognosis with nasal cases after rational therapy. The modified nomogram-revised index (including age, ECOG score, and LDH) and modified international prognostic index (including age, ECOG score, LDH, and number of extranodal involvement) functioned effectively for prognostic stratification in non-nasal type ENKTCLs.