Cancer Research and Treatment

Original Articles

Patterns of Failure and Survival Trends in 3,808 Patients with Stage II Nasopharyngeal Carcinoma Diagnosed from 1990 to 2012: A Large-Scale Retrospective Cohort Study: Xue-Song Sun, Di-Han Liu, Sai-Lan Liu, Qiu-Yan Chen, Shan-Shan Guo, Yue-Feng Wen, Li-Ting Liu, Hao-Jun Xie, Qing-Nan Tang, Yu-Jing Liang, Xiao-Yun Li, Jin-Jie Yan, Ming-Huang Hong, Jun Ma, Lin-Quan Tang, Hai-Qiang Mai; Cancer Res Treat. 2019;51(4):1449-1463. Published online March 7, 2019; DOI: https://doi.org/10.4143/crt.2018.688

Purpose
The purpose of this study was to investigate the survival trends and patterns of failure in patients with stage II nasopharyngeal carcinoma (NPC) treated with radiotherapy (RT) and chemotherapy over the last 20 years.
Materials and Methods
Thirty-eight hundred and eight patients diagnosed with stage II NPC between January 1990 and December 2012 were involved in this retrospective cohort study. All patients were treated with RT. According to the main imaging techniques and RT technology, we categorized these patients into four calendar periods: 1990-1996, 1997-2002, 2003-2007, and 2008-2012. Overall survival (OS), progression-free survival (PFS), locoregional relapse-free survival (LRFS), and distant metastasis–free survival (DMFS) were served as the clinical outcome.
Results
After a median follow-up period of 84.7 months, we observed increasing trends in survival and disease control. The 3- and 5-year OS rates increased from 87.1% and 78.7% in the first calendar period to 97.4% and 94.5% in the last calendar period, respectively (p<0.001). Additionally, significant increasing trends could be seen in the PFS and LRFS during the four calendar periods. In the subgroup analysis, the LRFS in patients older than 50 years at diagnosis showed greater improvement than younger patients. However, the rate of distant metastasis was stable and relatively low, as the 5-year DMFS ranged from 90.5% to 94.7% among the four calendar periods.
Conclusion
The survival rates in patients with stage II NPC showed increasing trends from 1990 to 2012. The advance of RT provided excellent locoregional control and enhanced OS.

Citations

Citations to this article as recorded by

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Jiachen Sun, Sai kit Edmond Lam, Xinzhi Teng, Jiang Zhang, Francis Kar-ho Lee, Celia Wai-yi Yip, James Chung-hang Chow, Victor Ho-fun Lee, Ying Sun, Jing Cai
Scientific Reports.2025;[Epub] CrossRef
ADAM22 acts as a novel predictive biomarker for unfavorable prognosis and facilitates metastasis via PI3K/AKT signaling pathway in nasopharyngeal carcinoma
Kaixiong Xu, Ping Jiang, Zui Chen, Xiaoqiong Gu, Ting Zhang
Pathology - Research and Practice.2024; 256: 155264. CrossRef
T1-2N1M0 nasopharyngeal carcinoma chemotherapy or not: A retrospective study
Pei-Jing Li, Ming Chen, Ye Tian, Seok Ho Lee
PLOS ONE.2023; 18(3): e0279252. CrossRef
Survival among subgroups of patients with stage II nasopharyngeal carcinoma
Shi-Ting Huang, Dan-Ke Su
Scientific Reports.2022;[Epub] CrossRef
Survival outcome and prognostic factors of patients with nasopharyngeal cancer in Yogyakarta, Indonesia: A hospital-based retrospective study
Susanna Hilda Hutajulu, Daniel Howdon, Kartika Widayati Taroeno-Hariadi, Mardiah Suci Hardianti, Ibnu Purwanto, Sagung Rai Indrasari, Camelia Herdini, Bambang Hariwiyanto, Ahmad Ghozali, Henry Kusumo, Wigati Dhamiyati, Sri Retna Dwidanarti, I. Bing Tan, J
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Explore the Usefulness of Concurrent Chemotherapy in Stage II Nasopharyngeal Carcinoma: A Retrospective Study
Pei-Jing Li, Yu-Lin Lai, Fang He, Yuan-Yuan Chen, Zhuo-Sheng Gu, Wei Luo, Qun Zhang
Frontiers in Pharmacology.2021;[Epub] CrossRef
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CD47 Overexpression Is Associated with Epstein–Barr Virus Infection and Poor Prognosis in Patients with Nasopharyngeal Carcinoma

Zhi-Hui Wang, Xiao-Feng Pei, Zhi-Quan Zhu, Zhong Lin, Yin-Yan Mao, Xiao-Lu Xu, You-Li Luo, Li Zhang, Pei-Jian Peng
OncoTargets and Therapy.2020; Volume 13: 3325. CrossRef
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Molecular Cancer.2020;[Epub] CrossRef

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The Prognostic Value of Treatment-Related Lymphopenia in Nasopharyngeal Carcinoma Patients: Li-Ting Liu, Qiu-Yan Chen, Lin-Quan Tang, Shan-Shan Guo, Ling Guo, Hao-Yuan Mo, Ming-Yuan Chen, Chong Zhao, Xiang Guo, Chao-Nan Qian, Mu-Sheng Zeng, Jin-Xin Bei, Jing Tan, Shuai Chen, Ming-Huang Hong, Jian-Yong Shao, Ying Sun, Jun Ma, Hai-Qiang Mai; Cancer Res Treat. 2018;50(1):19-29. Published online April 5, 2017; DOI: https://doi.org/10.4143/crt.2016.595

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study was conducted to evaluate the prognostic value of treatment-related lymphopenia in patients with nasopharyngeal carcinoma (NPC).
Materials and Methods
A total of 413 consecutive stage II-IVb NPC patients treated with concurrent chemoradiotherapy (CCRT) were enrolled. The overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival (DMFS) were calculated with the Kaplan-Meier method, and differences were compared using the log-rank test.
Results
A minimum (mini)–absolute lymphocyte counts (ALC) of < 390 cells/μL or ALC after 3 months of CCRT (post3m-ALC) < 705 cells/μL was significantly associated with worse outcome than mini-ALC ≥ 390 cells/μL (OS, p=0.002; PFS, p=0.005; DMFS, p=0.004) or post3m-ALC ≥ 705 cells/μL (OS, p < 0.001; PFS, p < 0.001; DMFS, p=0.001). Patients with lymphopenia (mini-ALC < 390 cells/μL and post3m-ALC < 705 cells/μL) had a worse prognosis than those without lymphopenia (mini-ALC ≥ 390 cells/μL and post3m-ALC ≥ 705 cells/μL) (OS, p < 0.001; PFS, p < 0.001; DMFS, p < 0.001). Multivariate analysis revealed that post3m-ALC was an independent prognostic factor for OS (hazard ratio [HR], 1.76; 95% confidence interval [CI], 1.12 to 2.78; p=0.015), PFS (HR, 1.86; 95% CI, 1.23 to 2.82; p=0.003), and DMFS (HR, 1.87; 95% CI, 1.13 to 3.08; p=0.014). Multivariate analysis also revealed that patients with lymphopenia had a high risk of death (HR, 3.79; 95% CI, 1.75 to 8.19; p=0.001), disease progression (HR, 2.93; 95% CI, 1.59 to 5.41; p=0.001), and distant metastasis (HR, 3.89; 95% CI, 1.67 to 9.10; p=0.002). Multivariate analysis performed with time dependent Cox regression demonstrated ALC was an independent prognostic factor for OS (HR, 0.995; 95% CI, 0.991 to 0.999; p=0.025) and PFS (HR, 0.993; 95% CI, 0.988 to 0.998; p=0.006).
Conclusion
Treatment-related lymphopenia was a poor prognostic factor in NPC patients.

Citations

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