biostudies-literatureUnknown7(2)Cao YCurrent 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 predictioCell reports. Medicine102617https://www.ebi.ac.uk/biostudies/studies/S-EPMC12923967biostudies-literatureA revised staging system for natural killer/T cell lymphoma incorporating skull base invasion and nasal/non-nasal subtype distinction.PMC12923967Jing HCai QCai PZhang HHuang HShuang YCai JQi SPeng ZZhao YWang LBai SZou QLi BSong YXia YNie MSun XFang XLi ZZhang YCao YYin QGao YTao RGao XZhong LfalseA revised staging system for natural killer/T cell lymphoma incorporating skull base invasion and nasal/non-nasal subtype distinction.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 predictio2026-01-01T00:00:00Z2026 Feb2026-07-16T14:53:47.769Z2026-07-09T11:01:14.611ZS-EPMC129239674167206510.1016/j.xcrm.2026.102617