title: Increased body mass index is associated with improved overall survival in extranodal natural killer/T-cell lymphoma, nasal type.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, Hunan, China.|The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China.
authors.forename: Ya-Jun
authors.initials: YJ
authors.lastname: Li
authors.affiliation: Department of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, Hunan, China.|The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China.
authors.forename: Ping-Yong
authors.initials: PY
authors.lastname: Yi
authors.affiliation: Department of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, Hunan, China.|The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China.
authors.forename: Ji-Wei
authors.initials: JW
authors.lastname: Li
authors.affiliation: Cancer Center of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Xian-Ling
authors.initials: XL
authors.lastname: Liu
authors.affiliation: Department of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, Hunan, China.|The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China.
authors.forename: Xi-Yu
authors.initials: XY
authors.lastname: Liu
authors.affiliation: Department of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, Hunan, China.|The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Zhou
authors.affiliation: Department of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, Hunan, China.|The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China.
authors.forename: Zhou
authors.initials: Z
authors.lastname: OuYang
authors.affiliation: Department of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, Hunan, China.|The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China.
authors.forename: Zhong-Yi
authors.initials: ZY
authors.lastname: Sun
authors.affiliation: Department of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, Hunan, China.|The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China.
authors.forename: Li-Jun
authors.initials: LJ
authors.lastname: Huang
authors.affiliation: Department of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, Hunan, China.|The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China.
authors.forename: Jun-Qiao
authors.initials: JQ
authors.lastname: He
authors.affiliation: Department of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, Hunan, China.|The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Yao
authors.affiliation: Department of Lymphoma and Hematology, Hunan Cancer Hospital, Changsha, Hunan, China.|The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China.
authors.forename: Zhou
authors.initials: Z
authors.lastname: Fan
authors.affiliation: The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China.|Radioactive Interventional Department, Hunan Cancer Hospital, Changsha, Hunan, China.
authors.forename: Tian
authors.initials: T
authors.lastname: Tang
authors.affiliation: State Key Laboratory of Oncology in South China, Guangzhou, China.|Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China.
authors.forename: Wen-Qi
authors.initials: WQ
authors.lastname: Jiang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000418:Albumins / Q000378:metabolism; D015992:Body Mass Index; D002648:Child; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D054391:Lymphoma, Extranodal NK-T-Cell / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D000418:Albumins; D007770:L-Lactate Dehydrogenase
keywords: IPI; KPI; body mass index; extranodal natural killer/T-cell lymphoma; prognosis