Increased body mass index is associated with improved overall survival in extranodal natural killer/T-cell lymphoma, nasal type
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Ya-Jun Li1,2, Ping-Yong Yi1,2, Ji-Wei Li1,2, Xian-Ling Liu3, Xi-Yu Liu1,2, Fang Zhou1,2, Zhou OuYang1,2, Zhong-Yi Sun1,2, Li-Jun Huang1,2, Jun-Qiao He1,2, Yuan Yao1,2, Zhou Fan1,2, Tian Tang2,4 and Wen-Qi Jiang5,6
1 Department of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, Hunan, China
2 The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
3 Cancer Center of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
4 Radioactive Interventional Department, Hunan Cancer Hospital, Changsha, Hunan, China
5 State Key Laboratory of Oncology in South China, Guangzhou, China
6 Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
Ping-Yong Yi, email:
Wen-Qi Jiang, email:
Keywords: body mass index, extranodal natural killer/T-cell lymphoma, prognosis, IPI, KPI
Received: April 26, 2016 Accepted: November 30, 2016 Published: December 16, 2016
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.
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