title: Clinical value of metabolic tumor volume by PET/CT in extranodal natural killer/T cell lymphoma.
abstract: This study investigated whether metabolic tumor volume (MTV) by PET/CT as indicator of extent of lymphoma burden would be a prognostic factor in stage I(E)/II(E) extranodal natural killer/T cell lymphoma (ENKTCL). Eighty patients with stage I(E)/II(E) ENKTCL in the upper aerodigestive tract underwent PET/CT at diagnosis were enrolled and 32 patients received upfront radiotherapy (RTx). MTV was measured on PET/CT images by the extranodal region above SUV, 2.5. Receiver operating curve analyses indicated that an MTV of 35.2 cm(3) was the ideal cut-off to distinguish between low and high MTV groups. Clinical outcomes were compared according to several prognostic factors (age, stage, high performance status [PS], high International Prognostic Index, elevated lactate dehydrogenase [LDH], local tumor invasiveness [LTI], high MTV and up-front RT). High PS, elevated LDH, LTI, high MTV and upfront RT were associated with survivals. In multivariate analysis, high MTV (PFS, HR=4.170, 95% CI=1.714-10.147, p=0.002; OS, HR=4.102, 95% CI=1.617-10.408, p=0.003) and up-front RT (PFS, HR=0.410, 95%CI=0.178-0.946, p=0.037; OS, HR=0.365, 95% CI=0.152-0.872, p=0.023) were significant independent prognostic factors. Upfront RTx and extent of tumor burden, as measured by the MTV, had significant prognostic value in patients with ENKTCL.
authors.affiliation: Department of Hematology-Oncology, Pusan National University Hospital Medical Research Institute, Busan, Republic of Korea. song9676@hanmail.net
authors.forename: Moo-Kon
authors.initials: MK
authors.lastname: Song
authors.forename: Joo-Seop
authors.initials: JS
authors.lastname: Chung
authors.forename: Ho-Jin
authors.initials: HJ
authors.lastname: Shin
authors.forename: Joon-Ho
authors.initials: JH
authors.lastname: Moon
authors.forename: Jae-Sook
authors.initials: JS
authors.lastname: Ahn
authors.forename: Ho-Sup
authors.initials: HS
authors.lastname: Lee
authors.forename: Sang-Min
authors.initials: SM
authors.lastname: Lee
authors.forename: Gyeong-Won
authors.initials: GW
authors.lastname: Lee
authors.forename: Seong-Jang
authors.initials: SJ
authors.lastname: Kim
authors.forename: Seok-Mo
authors.initials: SM
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D054391:Lymphoma, Extranodal NK-T-Cell / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D049268:Positron-Emission Tomography; D012372:ROC Curve; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden