Yi-Kan Cheng1, Fan Zhang2, Ling-Long Tang2, Lei Chen2, Guan-Qun Zhou2, Mu-Sheng Zeng3, Tie-Bang Kang3, Wei-Hua Jia3, Jian-Yong Shao4, Hai-Qiang Mai5, Ying Guo6, Jun Ma7. 1. State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China; Department of Radiation Oncology, The Sixth Affiliated Hospital of Sun Yat-sen University (Gastrointestinal and Anal Hospital of Sun Yat-sen University), Yuancun Er Heng Lu, Guangzhou, People's Republic of China. 2. State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China. 3. State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Cancer Center, Sun Yat-sen University, Guangzhou, People's Republic of China. 4. State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Molecular Diagnostics, Cancer Center, Sun Yat-sen University, Guangzhou, People's Republic of China. 5. State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Nasopharyngeal Cancer, Cancer Center, Sun Yat-sen University, Guangzhou, People's Republic of China. 6. State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of National Clinical Study Center for Anticancer Drugs, Cancer Center, Sun Yat-sen University, Guangzhou, People's Republic of China. 7. State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China. Electronic address: majun2@mail.sysu.edu.cn.
Abstract
BACKGROUND: Pregnancy-associated nasopharyngeal carcinoma (PANPC) has been associated with poor survival. Recent advances in radiation technology and imaging techniques, and the introduction of chemotherapy have improved survival in nasopharyngeal carcinoma (NPC); however, it is not clear whether these changes have improved survival in PANPC. Therefore, the purpose of this study was to compare five-year maternal survival in patients with PANPC and non-pregnant patients with NPC. METHODS: After adjusting for age, stage and chemotherapy mode, we conducted a retrospective case-control study among 36 non-metastatic PANPC patients and 36 non-pregnant NPC patients (control group) who were treated at our institution between 2000 and 2010. RESULTS: The median age of both groups was 30years (range, 23-35years); median follow-up for all patients was 70months. Locoregionally-advanced disease accounted for 83.3% of all patients with PANPC and 92.9% of patients who developed NPC during pregnancy. In both the PANPC and control groups, 31 patients (86.1%) received chemotherapy and all patients received definitive radiotherapy. The five-year rates for overall survival (70% vs. 78%, p=0.72), distant metastasis-free survival (79% vs. 76%, p=0.77), loco-regional relapse-free survival (97% vs. 91%, p=0.69) and disease-free survival (69% vs. 74%, p=0.98) were not significantly different between the PANPC and control groups. Multivariate analysis using a Cox proportional hazards model revealed that only N-classification was significantly associated with five-year OS. CONCLUSION: This study demonstrates that, in the modern treatment era, pregnancy itself may not negatively influence survival outcomes in patients with NPC; however, pregnancy may delay the diagnosis of NPC.
BACKGROUND: Pregnancy-associated nasopharyngeal carcinoma (PANPC) has been associated with poor survival. Recent advances in radiation technology and imaging techniques, and the introduction of chemotherapy have improved survival in nasopharyngeal carcinoma (NPC); however, it is not clear whether these changes have improved survival in PANPC. Therefore, the purpose of this study was to compare five-year maternal survival in patients with PANPC and non-pregnant patients with NPC. METHODS: After adjusting for age, stage and chemotherapy mode, we conducted a retrospective case-control study among 36 non-metastatic PANPC patients and 36 non-pregnant NPCpatients (control group) who were treated at our institution between 2000 and 2010. RESULTS: The median age of both groups was 30years (range, 23-35years); median follow-up for all patients was 70months. Locoregionally-advanced disease accounted for 83.3% of all patients with PANPC and 92.9% of patients who developed NPC during pregnancy. In both the PANPC and control groups, 31 patients (86.1%) received chemotherapy and all patients received definitive radiotherapy. The five-year rates for overall survival (70% vs. 78%, p=0.72), distant metastasis-free survival (79% vs. 76%, p=0.77), loco-regional relapse-free survival (97% vs. 91%, p=0.69) and disease-free survival (69% vs. 74%, p=0.98) were not significantly different between the PANPC and control groups. Multivariate analysis using a Cox proportional hazards model revealed that only N-classification was significantly associated with five-year OS. CONCLUSION: This study demonstrates that, in the modern treatment era, pregnancy itself may not negatively influence survival outcomes in patients with NPC; however, pregnancy may delay the diagnosis of NPC.