Background & objective: The prognosis of primary non-Hodgkin's lymphoma (NHL) of the nasal cavity was poor, and the distant metastasis and local relapse rates are high. This study was to analyze the prognostic factors of this disease.
Methods: Clinical data of 129 patients with pathologically confirmed nasal NHL, treated from Jan. 1996 to Dec. 2002, were retrospectively reviewed. Of the 129 patients, 116 were diagnosed as nasal NK/T-cell lymphoma. According to the Ann Arbor staging system, 102 patients had stage IE disease, 22 stage IIE, and 5 stage IVE. Among the 124 patients with stage IE or IIE disease, 22 received radiotherapy alone, 7 received chemotherapy alone, and 95 received combined modality therapy (CMT). Of the patients received CMT, 45 received radiotherapy followed by chemotherapy, and 50 received chemotherapy followed by radiotherapy. The stage IVE patients received chemotherapy with or without radiotherapy.
Results: The 5-year overall survival (OS) and disease-freely survival (DFS) rates for all patients were 68.0% and 55.8%, respectively. The 5-year OS and DFS rates were 71.7% and 60.9% for stage IE patients, and 70.6% and 47.0% for stage IIE patients, respectively (P>0.05). The 5-year OS and DFS rates were significantly higher in the patients who achieved complete response (CR) than in those who didn't (83.1% vs. 18.0%, 68.0% vs. 15.5%, P<0.01). The 5-year OS rates of the patients with international prognostic index (IPI) score of 0, 1, and > or =2 were 81.1%, 60.1%, and 14.3% (P<0.01), respectively; the 5-year DFS rates were 68.8%, 44.6%, and 22.5% (P<0.01), respectively. Thirty-eight patients developed progression or relapse, with distant extranodal dissemination (78.9%) as the primary pattern of failure. Univariate analysis showed that CR rate, PS, IPI, and modified IPI were related to prognosis. Multivariate analysis showed that CR rate was an independent prognostic factor.
Conclusions: CR rate after treatment is an important prognostic factor of nasal NHL. Distant metastasis is the main failure pattern of nasal NHL.