A revised staging system for natural killer/T cell lymphoma incorporating skull base invasion and nasal/non-nasal subtype distinction
Year: 2026
Type: article
Study design: Observational Study
Abstract: Current staging systems for natural killer/T cell lymphoma (NKTCL) inadequately reflect its predominantly extranodal presentation and lack prognostic accuracy in the asparaginase era. This retrospective multicenter study analyzes 1,872 newly diagnosed NKTCL patients treated with asparaginase-based regimens or radiotherapy alone, from 15 institutions across China. For nasal-type NKTCL, skull base invasion (SBI) is identified as an independent adverse prognostic factor. We reclassify Ann Arbor stage I patients with SBI as stage II and stage II patients with SBI as stage III. For non-nasal-type NKTCL, we retain the Chinese Southwest Oncology Group and Asia Lymphoma Study Group (CA) system due to its superior prognostic discrimination. The revised system demonstrates improved outcome prediction, hazard discrimination, hazard consistency, and sample balance across training, internal, and external validation cohorts. Time-dependent receiver operating characteristic (ROC) analysis confirms superior predictive accuracy over existing systems. This proposal provides a refined prognostic framework to guide clinical decision-making and optimize patient selection for future trials.
Source: Cell Reports Medicine
Authors: Yi Cao, Yuchen Zhang, Liang Wang, Yongping Song, Shunan Qi, Peiqiang Cai, Rong Tao, Zhihua Li, Yuerong Shuang, Qingsong Yin, Zhigang Peng, Liye Zhong, Xiuhua Sun, Hongyu Zhang, Ying Zhao, Hongmei Jing, Bingzong Li, Qihua Zou, Huiqiang Huang, Yan Gao, Yi Xia, Man Nie, Xiaojie Fang, Xinna Gao, Shenrui Bai, Jun Cai, Qingqing Cai
Institutions: Sun Yat-sen University, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Beijing Tongren Hospital, Capital Medical University, First Affiliated Hospital of Zhengzhou University, Chinese Academy of Medical Sciences & Peking Union Medical College, Fudan University Shanghai Cancer Center, Sun Yat-sen Memorial Hospital, Jiangxi Provincial Cancer Hospital, Zhengzhou University, Henan Cancer Hospital, Guangxi Medical University, First Affiliated Hospital of GuangXi Medical University, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Southern Medical University, Dalian Medical University, Second Affiliated Hospital of Dalian Medical University, Peking University Shenzhen Hospital, First People's Hospital of Foshan, Peking University Third Hospital, Soochow University, Second Affiliated Hospital of Soochow University, Suzhou University
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $5,620
Funders: National Natural Science Foundation of China, Sun Yat-sen University, Chinese Society of Clinical Oncology, Guangzhou Science and Technology Program key projects, National Postdoctoral Program for Innovative Talents, Key Technologies Research and Development Program, National Key Research and Development Program of China
OpenAlex ID: W7128483504