title: A TNM Staging System for Nasal NK/T-Cell Lymphoma.
abstract: Ann Arbor stage has limited utility in the prognostication and treatment decision making in patients with NK/T-cell lymphoma (NKTCL), as NKTCL is almost exclusively extranodal and the majority is localized at presentation for which radiotherapy is the most important treatment and local invasiveness is the most important prognostic factor. In this study, we attempted to establish a TNM (Tumor-Node-Metastasis) staging system for nasal NKTCL (N-NKTCL). The staging rules of other head and neck cancers were used as reference along with the data of our 271 eligible patients. The primary tumor was classified into T1 to T4, and cervical lymph node metastasis was classified into N0 to N2 according to the extent of involvement. Any lesions outside the head and neck were classified as M1. N-NKTCL thereby was classified into four stages: stage I comprised T1-2N0M0; stage II comprised T1-2N1M0 and T3N0M0; stage III comprised T3N1M0, T1-3N2M0, and T4N0-2M0; and stage IV comprised TanyNanyM1. This staging system showed excellent performance in prognosticating survival. In the current series, the 5-year survival rates of patients with stages I, II, III, and IV N-NKTCL were 92%, 64%, 23%, and 0, respectively. Moreover, the predictive value of several currently used factors was abrogated in the presence of the TNM stage. The TNM staging system is highly effective in stratifying tumor burden and survival risk, which may have significant implications in the treatment decision making for patients with N-NKTCL.
authors.affiliation: Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China; Stage Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Yan
authors.affiliation: Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China; Stage Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
authors.forename: Hui-qiang
authors.initials: HQ
authors.lastname: Huang
authors.affiliation: Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China; Stage Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
authors.forename: Xiao-xiao
authors.initials: XX
authors.lastname: Wang
authors.affiliation: Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China; Stage Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Stage Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China; Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.
authors.forename: Yu-jing
authors.initials: YJ
authors.lastname: Zhang
authors.affiliation: Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China; Stage Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Bai
authors.affiliation: Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China; Stage Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhao
authors.affiliation: Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China; Stage Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
authors.forename: Wen-qi
authors.initials: WQ
authors.lastname: Jiang
authors.affiliation: Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China; Stage Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
authors.forename: Zhi-ming
authors.initials: ZM
authors.lastname: Li
authors.affiliation: Stage Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China; Department of Hematology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.
authors.forename: Zhong-jun
authors.initials: ZJ
authors.lastname: Xia
authors.affiliation: Stage Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China; Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.
authors.forename: Su-xia
authors.initials: SX
authors.lastname: Lin
authors.affiliation: Stage Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China; Medical Imaging Department, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.
authors.forename: Chuan-miao
authors.initials: CM
authors.lastname: Xie
mesh_terms: D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000473:pathology; D054391:Lymphoma, Extranodal NK-T-Cell / Q000175:diagnosis* / Q000473:pathology; D009367:Neoplasm Staging / Q000379:methods*; D009669:Nose Neoplasms / Q000175:diagnosis* / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies