Tumor necrosis and complete resection has significant impacts on survival in patients with limited-stage upper aerodigestive tract NK/T cell lymphoma

Tumor necrosis (TN) is associated with worse prognosis in several solid cancers. Whether TN predicts poor outcome in natural killer cell / T cell lymphoma (NKTCL) is unclear. We investigated the clinical impact of TN on survival and other novel prognostic parameters in upper aero-digestive tract (UAT) NKTCL of 100 patients with limited stage. TN was significantly associated with poor performance status ( = 0.049), high Korean Prognostic Index score ( = 0.024), high C-reactive protein/albumin ratio ( = 0.003), higher maximum standard uptake value on positron emission tomography/computed tomography (PET/CT) ( = 0.008) and higher metabolic tumor volume (MTV) on PET/CT ( < 0.001). In univariate and multivariate analyses, progression-free survival and overall survival were independently associated with High MTV status ( = 0.001, = 0.032), TN ( = 0.018, = 0.009), local tumor invasiveness ( = 0.007, = 0.035), complete resection ( = 0.020, = 0.028) and regional lymph node involvement ( < 0.001, < 0.001). TN and complete resection are concluded to be novel independent prognostic factors in patients with UAT NKTCL.