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Purpose The aim of the present study was to evaluate the prognostic value of magnetic resonance imaging (MRI)!determined lymph nodal necrosis (LNN) in nasopharyngeal carcinoma (NPC) and explore the feasibility of an N-classification system based on the 8th edition of the American Joint Committee on Cancer (AJCC) system. Materials and Methods The MRI scans of 616 patients with newly diagnosed stage T1-4N1-3M0 NPC who were treated with definitive intensity-modulated radiotherapy were reviewed. Results Multivariate analysis showed that LNN was an independent negative prognostic predictor of distant metastasis free survival (hazard ratio, 1.634; 95% confidence interval, 1.023 to 2.609; p=0.040) and overall survival (hazard ratio, 2.154; 95% confidence interval, 1.282 to 3.620; p=0.004). Patients of classification N1 disease with LNN were reclassified as classification N2, and classification N2 disease with LNN as classification N3 in the proposed N-classification system. Correlation with death and distant failure was significant, and the total difference between N1 and N3 was wider with the proposed system. Conclusion MRI-determined LNN is an independent negative prognostic factor for NPC. The proposed N classification system is powerfully predictive. [ABSTRACT FROM AUTHOR]

Purpose The aim of this study is to evaluate the prognostic significance of paranasal sinus invasion for nasopharyngeal carcinoma (NPC) and its suitable position in the T classification. Materials and Methods The magnetic resonance imaging (MRI) scans of 695 patients with previously untreated, biopsy-proven, non-metastatic NPC that was treated with intensity-modulated radiotherapy (IMRT) were reviewed retrospectively. Results The incidence of paranasal sinus invasion was 39.4% (274 of 695 patients). Multivariate analysis showed that paranasal sinus invasion was an independent negative prognostic factor for local failure-free survival (LFFS) (p < 0.05). According to the eighth American Joint Committee on Cancer (AJCC) staging system, 275 patients were classified as T3 classification. Of these, 78 patients (28.4%) developed paranasal sinus invasion (T3b) and 197 (71.6%) didn't (T3a). The estimated 5-year LFFS and overall survival (OS) rates for the patients with T3b and T3a classification were 88.6% versus 95.0% (p=0.047), and 84.5% versus 93.3% (p=0.183), respectively. The estimated 5-year LFFS and OS rates for the patients with T4 classification were 89.5% and 83.2%, which were similar with the outcomes of patients with T3b classification. Conclusion MRI-determined paranasal sinus invasion is an independent prognostic factor of NPC treated by IMRT. Paranasal sinus invasion is recommended to classify as T4 classification in the 8th AJCC staging system for NPC. [ABSTRACT FROM AUTHOR]

Purpose This study was conducted is to identify the prognostic value and staging categories of magnetic resonance imaging (MRI)-detected intracranial extension in nasopharyngeal carcinoma (NPC) with intensity-modulated radiotherapy (IMRT) to determine whether it is necessary to subclassify the T4 classification NPC. Materials and Methods A total of 335 nonmetastatic T4 classification NPC patients with MRI treated between March 2004 and June 2011 by radical IMRT were included. The T4 classification patients were subclassified into two grades (T4a, without intracranial extension vs. T4b, with intracranial extension) according to the site of invasion. Results The frequency of intracranial extension was 40.9% (137 of 335 patients). Multivariate analysis identified subclassification (T4a vs. T4b) as an independent prognostic factor for local failure-free survival (p=0.049; hazard ratio [HR], 0.498) and overall survival (p=0.004; HR, 0.572); however, it had no effect on regional failure-free survival or distant failure-free survival (p > 0.050). Conclusion For patients with T4 classification NPC, those with MRI-detected intracranial extension are more likely to experience local failure and death after IMRT than patients without intracranial extension. According to the site of invasion, subclassification of T4 patients as T4a or T4b has prognostic value in NPC. [ABSTRACT FROM AUTHOR]

The aim of the present study was to summarize the clinical characteristics of primary breast lymphoma (PBL) and evaluate its management approaches. A total of 29 patients newly diagnosed with PBL, and treated between April 2006 and May 2013, were analyzed retrospectively. The median survival follow-up time for all patients was 66.8 (range, 25.4-110.0) months. The results of the follow-up revealed 22 living lymphoma-free patients and 7 patients who had succumbed to PBL. Of the 7 deceased patients, 6 had succumbed to lymphoma and 1 to chemotherapy-associated hepatic failure. In total, 1 patient who presented with bilateral breast lymphoma developed left breast relapse following lumpectomy and chemotherapy, 2 patients developed a bone marrow relapse, 1 patient developed lung and mediastinal lymph node relapses, and 1 patient developed a skin relapse. The Kaplan-Meier estimator predicted 5-year overall survival and progression-free survival rates for all patients of 74.4 and 74.6%, respectively. PBL appears to be a rare disease with a good overall prognosis and low incidence of local relapse, following chemotherapy alone or in combination with other treatments. Further studies investigating the development of effective agents for use in treatment-resistant patients are required. [ABSTRACT FROM AUTHOR]

Background and objective: The objective of the study was to evaluate the efficiency of chemotherapy (CT) combined with high-dose extended-field radiotherapy (RT) in stage I extranodal nasal-type natural killer/T-cell lymphoma (NKTCL). Patients and methods: Between January 2001 and November 2010, 103 stage I extranodal nasal-type NKTCL patients were retrospectively analyzed. Of these patients, 75 patients were treated by RT plus CT and 28 patients were treated by RT alone. CT included cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), or CHOP-like regimen. Results: The median follow-up time was 42.6 months (range, 7.4-126.7 months). For patients in the RT alone group, the 5-year estimated progression-free survival (PFS) and overall survival (OS) rates were 67.0% and 71.4%, respectively. For patients in the RT + CT group, the 5-year estimated PFS and OS rates were 69.0% and 63.7%, respectively. In multivariate analysis, CT was an independent factor for PFS. Conclusion: The doxorubicin-based CT combined with high-dose extended-field RT yielded promising outcomes for stage I extranodal nasal-type NKTCL, and CT was an independent factor for PFS. [ABSTRACT FROM AUTHOR]

Background and objective: The aim of this study was to summarize the clinical characteristics and evaluate the management approaches of primary breast diffuse large B-cell lymphoma (DLBCL) in the era of rituximab. Patients and methods: A total of 24 female patients with newly diagnosed primary breast DLBCL treated between April 2006 and May 2013 were analyzed retrospectively. Ten patients (41.7%) received rituximab. Results: For the whole group, the median age was 50 years (range 24-69 years). All patients had the disease detected with a palpable mass. The estimated 5-year overall survival and progressionfree survival (PFS) rates of all the patients were 78.9% and 79.2%, respectively. A nonstatistically significant increase in PFS and overall survival was observed when rituximab was administered (5-year PFS: 90% vs 71.4%, P=0.285; 5-year overall survival: 90% vs 71.4%, P=0.239). Conclusion: Primary breast DLBCL appears to be a rare disease. Adding rituximab might improve survival in patients with primary breast DLBCL. Further prospective studies are needed to evaluate the role of rituximab for primary breast DLBCL. [ABSTRACT FROM AUTHOR]