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Research Paper|Volume 11, Issue 19|pp 8463—8473

Effect of age as a continuous variable on survival outcomes and treatment selection in patients with extranodal nasal-type NK/T-cell lymphoma from the China Lymphoma Collaborative Group (CLCG)

Wei-Xin Liu1, Mei Shi2, Hang Su3, Ying Wang4, Xia He5, Li-Ming Xu6, Zhi-Yong Yuan6, Li-Ling Zhang7, Gang Wu7, Bao-Lin Qu8, Li-Ting Qian9, Xiao-Rong Hou10, Fu-Quan Zhang10, Yu-Jing Zhang11, Yuan Zhu12, Jian-Zhong Cao13, Sheng-Min Lan13, Jun-Xin Wu14, Tao Wu15, Su-Yu Zhu16, Shu-Nan Qi1, Yong Yang1, Bo Chen1, Ye-Xiong Li1
  • 1State Key Laboratory of Molecular Oncology and Department of Radiation Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, P. R. China
  • 2Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, P. R. China
  • 3307 Hospital, Academy of Military Medical Science, Beijing, P. R. China
  • 4Chongqing Cancer Hospital and Cancer Institute, Chongqing, P. R. China
  • 5Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing, P. R. China
  • 6Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin, P. R. China
  • 7Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P. R. China
  • 8The General Hospital of Chinese People's Liberation Army, Beijing, P. R. China
  • 9The Affiliated Provincial Hospital of Anhui Medical University, Hefei, P. R. China
  • 10Peking Union Medical College Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, P. R. China
  • 11Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China
  • 12Zhejiang Cancer Hospital, Hangzhou, P. R. China
  • 13Shanxi Cancer Hospital and the Affiliated Cancer Hospital of Shanxi Medical University, Taiyuan, P. R. China
  • 14Fujian Provincial Cancer Hospital, Fuzhou, Fujian, P. R. China
  • 15Affiliated Hospital of Guizhou Medical University, Guizhou Cancer Hospital, Guiyang, P. R. China
  • 16Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, P. R. China
* Equal contribution
Received: July 12, 2019Accepted: September 22, 2019Published: October 6, 2019
https://doi.org/10.18632/aging.102331

Copyright © 2019 Liu et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Purpose: The aim of this study was to determine the impact of analyzing age as a continuous variable on survival outcomes and treatment selection for extranodal nasal-type NK/T-cell lymphoma.

Results: The risk of mortality increased with increasing age, without an apparent cutoff point. Patients’ age, as a continuous variable, was independently associated with overall survival after adjustment for covariates. Older early-stage patients were more likely to receive radiotherapy only whereas young-adult advanced-stage patients tended to receive non-anthracycline-based chemotherapy. A decreased risk of mortality with radiotherapy versus chemotherapy only in early-stage patients (HR, 0.347, P < 0.001) or non-anthracycline-based versus anthracycline-based chemotherapy in early-stage (HR, 0.690, P = 0.001) and advanced-stage patients (HR, 0.678, P = 0.045) was maintained in patients of all ages.

Conclusions: These findings support making treatment decisions based on disease-related risk factors rather than dichotomized chronological age.

Patients and Methods: Data on 2640 patients with extranodal nasal-type NK/T-cell lymphoma from the China Lymphoma Collaborative Group database were analyzed retrospectively. Age as a continuous variable was entered into the Cox regression model using penalized spline analysis to determine the association of age with overall survival (OS) and treatment benefits.